NPIMap

Individual provider Active NPI

Jonathan Edward Caudle, FNP-C

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1437658960
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902847 Issued in MS
Practice address
830 S Gloster St
Tupelo, MS 38801
Phone
(662) 377-3000
NPI assigned
Feb 10, 2018
Last updated
Nov 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0993670-NP CO
Family Nurse Practitioner 363LF0000X 902847 MS Primary

Addresses

Primary practice location

830 S Gloster St
Tupelo, MS 38801

Mailing address

830 S Gloster St
Tupelo, MS 38801-4996
Phone (662) 377-3000

Other practice location 1

135 County Highway 162
Brilliant, AL 35548-4103
Phone (205) 412-4462

Other practice location 2

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TX, AK3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20181218001925 MS Practitioner - Nurse Practitioner 5395080485 Reassigns benefits to 5 organizations
I20230906002801 TX Practitioner - Nurse Practitioner 5395080485 Reassigns benefits to 2 organizations
I20250318002466 AK Practitioner - Nurse Practitioner 5395080485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1204 Seward Ave
Searhc 1204 Behavioral Health Sitka
Sitka, AK 99835-7359
Phone (907) 966-8611

1206 Seward Ave
Searhc 1206 Behavioral Health Sitka
Sitka, AK 99835-7359
Phone (907) 966-8611

1209 Seward Ave
Searhc 1209 Behavioral
Sitka, AK 99835-7359
Phone (907) 966-8611

131 1St S St
Searchc Haines Medical Clinic
Haines, AK 99827-0389
Phone (907) 766-2521

222 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

227 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0993670-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Sound Health Corporation CurrentSince Feb 3, 2025 Accepting new patients
Norton Sound Health Corporation Current Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Norton Sound Health Corporation CurrentSince Feb 3, 2025 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Oct 4, 2023 Accepting new patients
Relias Emergency Medicine Specialists of Hattiesburg LLC CurrentSince Jun 1, 2020 Accepting new patients
Webster Health Services, Inc. CurrentSince Mar 18, 2020 Accepting new patients
Relias Hospitalist Medicine Specialists of Tupelo LLC CurrentSince May 10, 2022 Accepting new patients
Pontotoc Health Services, Inc. CurrentSince Mar 19, 2020 Accepting new patients
Webster Health Services, Inc. CurrentSince Mar 18, 2020 Accepting new patients
Relias Emergency Medicine Specialists of Tupelo LLC CurrentSince Aug 1, 2019 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Oct 4, 2023 Accepting new patients
Pontotoc Health Services, Inc. CurrentSince Mar 19, 2020 Accepting new patients
Webster Health Services, Inc. Current Accepting new patients
Southeast Alaska Regional Health Consortium Past Accepting new patients

Locations

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

70 Medical Plz
Eupora, MS 39744
Phone (662) 258-6221

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

176 S Main St
Pontotoc, MS 38863
Phone (601) 489-5510

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1518220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1437658960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014996",
            "telephone_number": "662-377-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "38801",
            "telephone_number": "662-377-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 County Highway 162",
            "address_purpose": "LOCATION",
            "city": "Brilliant",
            "state": "AL",
            "postal_code": "355484103",
            "country_code": "US",
            "telephone_number": "205-412-4462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "830 S Gloster St",
            "address_purpose": "LOCATION",
            "city": "Tupelo",
            "state": "MS",
            "postal_code": "38801",
            "country_code": "US",
            "telephone_number": "662-377-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAUDLE",
        "first_name": "JONATHAN",
        "middle_name": "EDWARD",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-10",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0993670-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.