Mindy Jo Edna Williamson, F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R876935 Issued in MS

Practice address

970 Lakeland Dr Ste 61
Jackson, MS 39216-4634

Phone

(662) 552-2512

NPI assigned

Aug 10, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mindy Jo Edna Byrd Former name

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kings Daughters Medical CenterGroup PAC ID 3072575539, 75 clinicians

Jackson Heart Clinic. P.a.Group PAC ID 0547204091, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057
• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Kings Daughters Medical Center

  • Anesthesiology Physician
  • Brookhaven, MS
  • NPI 1043245368
  Medicare reassignment Care Compare group NPD
• Jackson Heart Clinic. P.a.

  • Cardiovascular Disease Physician
  • Jackson, MS
  • NPI 1659318558
  Medicare reassignment Care Compare group
• King'S Daughters Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Brookhaven, MS
  • NPI 1881476364
  NPD
• King'S Daughters Medical Center

  • General Acute Care Hospital
  • Brookhaven, MS
  • NPI 1972503464
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Critical Access Hospital
  • Lexington, MS
  • NPI 1386630705
  NPD (past)

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

• King'S Daughters Medical Center

  • General Acute Care Hospital
  • Brookhaven, MS
  • NPI 1972503464
  Care Compare affiliation
• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1376858761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 LAKELAND DR STE 61",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164634",
            "telephone_number": "601-982-7850",
            "fax_number": "601-366-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 LAKELAND DR STE 61",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164634",
            "telephone_number": "662-552-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "MINDY JO",
        "middle_name": "EDNA",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R876935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINDY JO",
            "last_name": "BYRD",
            "middle_name": "EDNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Williamson
• Aubrey Duane Williamson, MD
• Kathlene Williamson, C.F.N.P.
• Kevin Paul Williamson, B.S.
• Linda Gail Williamson, CRNA
• Qianwen Williamson
• Veronica Nicole Williamson
• Andria Willis, BSW
• Chan Willis
• Kayla Childress Willis

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.