Individual provider Active NPI

Dietriche Stewart Jones, DNP, FNP-BC

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1376724799
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R856204 Issued in MS
Practice address
1041 S Madison St
Tupelo, MS 38801-6391
Phone
(662) 844-8754
NPI assigned
Nov 14, 2007
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R856204 MS Primary

Addresses

Primary practice location

1041 S Madison St
Tupelo, MS 38801-6391

Mailing address

1041 S Madison St
Tupelo, MS 38801-6391
Phone (662) 844-8754

Other practice location 1

495 S Gloster St
Tupelo, MS 38801-5539
Phone (662) 844-8754

Other identifiers 1

IdentifierTypeStateIssuer
01704876MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080408000049 MS Practitioner - Nurse Practitioner 5698852226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanders Clinic for Women P.a.Group PAC ID 9537136254, 12 clinicians

Practice addresses (Care Compare)

1041 S Madison St
Tupelo, MS 38801-6309
Phone (601) 844-8754

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Current Accepting new patients
Sanders Clinic for Women PA CurrentSince May 1, 2025 Accepting new patients

Locations

1041 S Madison St
Tupelo, MS 38801
Phone (601) 844-8754

495 S Gloster St
Ste M2
Tupelo, MS 38801
Phone (662) 844-8754

Interoperability endpoints

  • Direct secure messaging: dietriche.jones.1@13706.direct.athenahealth.com
  • Direct secure messaging: dietrichejones@nmhs.medalliesdirect.net
  • FHIR API: https://api.platform.athenahealth.com/13706/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1376724799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016391",
            "telephone_number": "662-844-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016391",
            "telephone_number": "662-844-8754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "495 S Gloster St",
            "address_purpose": "LOCATION",
            "city": "Tupelo",
            "state": "MS",
            "postal_code": "388015539",
            "country_code": "US",
            "telephone_number": "662-844-8754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "DIETRICHE",
        "middle_name": "STEWART",
        "name_prefix": "Mrs.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-14",
        "last_updated": "2026-09-29",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R856204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01704876",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.