Koscher Denee Jackson, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R865579 Issued in MS

Practice address

613 Marquette Rd
Brandon, MS 39042-3038

Phone

(601) 824-0342

Fax

(601) 824-0349

NPI assigned

Oct 8, 2014

Last updated

Mar 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjackson5391@ummc.direct-ci.com

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.

• Madison Rankin Simpson Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brandon, MS
  • NPI 1063428761
  NPD
• Region Ten Commission State of Ms

  dba Weems Community Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Meridian, MS
  • NPI 1073626511
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• Cares Center Inc

  • Psychiatric Residential Treatment Facility
  • Jackson, MS
  • NPI 1639382690
  NPD (past)

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1417350182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390430088",
            "telephone_number": "601-824-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 MARQUETTE RD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423038",
            "telephone_number": "601-824-0342",
            "fax_number": "601-824-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KOSCHER",
        "middle_name": "DENEE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-08",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R865579",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R865579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R865579",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Austin Ishee
• Ashley Ivy
• J. Brad Madden, MD Family Medicine
• Makayla Jacks
• Callen Deyoung Jackson, DMD
• Natosha Jackson
• Ruby J Jackson, DPC, LPC-S, NCC
• Dominic Arthur Jaeger, MD
• Karon Lee James
• Janus RX LLC

• Psychiatric/Mental Health Nurse Practitioner in Brandon, MS
• Providers in Brandon, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.