Individual provider Active NPI

Ebone' Sade' Singleton

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1437719192
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903382 Issued in MS
Practice address
1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116
Phone
(601) 362-4471
NPI assigned
Jun 15, 2019
Last updated
Oct 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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 903382 MS Primary

Addresses

Primary practice location

1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116

Mailing address

124 Links Dr Apt 204K
Canton, MS 39046-5388

Other practice location 1

124 Links Dr Apt 204K
Canton, MS 39046-5388
Phone (601) 667-9979

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
I20201116000039 MS Practitioner - Nurse Practitioner 0840600235 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
U-First Medical Clinic Family CurrentSince May 1, 2021 Accepting new patients

Locations

3276 S Liberty St
Canton, MS 39046
Phone (601) 407-1137

Interoperability endpoints

  • Direct secure messaging: ebone.singleton.p1@direct.magnoliamedical.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1560556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1437719192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 LINKS DR APT 204K",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390465388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165116",
            "telephone_number": "601-362-4471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 Links Dr Apt 204K",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MS",
            "postal_code": "390465388",
            "country_code": "US",
            "telephone_number": "601-667-9979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SINGLETON",
        "first_name": "EBONE'",
        "middle_name": "SADE'",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-15",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.