Marcus Berry, NP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Jackson, MS
NPI 1447710223 · NPPES record last updated Jun 27, 2025
Key facts
- NPI
- 1447710223
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 903253 (MS)
- Practice address
- 3304 N State St Ste 201a
Jackson, MS 39216-3129 - Phone
- (601) 258-9121
- NPI assigned
- Mar 20, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220425000569 | MS | Practitioner - Nurse Practitioner | 3173910098 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Mississippi, PLLC | Family | Current |
Accepting new patients |
| Fast Pace Mississippi, PLLC | Current |
Accepting new patients | |
| Premier Elevation Health & Wellness, PLLC | Current |
Accepting new patients |
Locations
3304 N State St
Ste 201A
Jackson, MS 39216
Phone (601) 258-9121
517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 903253 | MS | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 903253 | MS | Yes |
Addresses
Primary practice location
3304 N State St Ste 201a
Jackson, MS 39216-3129
Mailing address
5070 Sunnyvale Dr
Jackson, MS 39211-4843
Phone (662) 213-5784
Other providers in Jackson, MS
- Patrick Finley Bergin
- William Paul Berlin Jr.
- John Paul Berman
- Jonny Berry
- Kristen Berry
- Ray M Berry
- Regina Berry
- Teddi Leigh Berry
- Thomas Blake Berry
- Willie Mae Berry
All providers in Jackson, MS · Psychiatric/Mental Health Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.