Active NPI
Diane C. Jakins, ACNP
- Acute Care Nurse Practitioner
- Gulfport, MS
National Provider Identifier
1457543183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- R772563
- Practice address
- 400 Security SQ
Gulfport, MS 39507-1932 - Phone
- (228) 865-1330
- Fax
- (228) 865-1331
- NPI assigned
- Aug 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | R772563 | MS | Primary |
Addresses
Primary practice location
400 Security SQ
Gulfport, MS 39507-1932
Mailing address
400 Security SQ
Gulfport, MS 39507-1932
Phone (228) 865-1330
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01282761 | Medicaid | MS |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-5201
Hospital & facility affiliations
- Memorial Hospital at Gulfport
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R772563 | MS | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital at Gulfport | Current | Accepting new patients | |
| Saad Enterprises, Inc. | Current | Accepting new patients | |
| Memorial Hospital at Gulfport | Current | Accepting new patients | |
| Memorial Hospital at Gulfport | Current | Accepting new patients | |
| Memorial Hospital at Gulfport | Past | Accepting new patients |
Locations
1515 S University Blvd
Mobile, AL 36609
Phone (251) 287-8886
10598 Diberville Blvd
Diberville, MS 39540
Phone 2513439600 ext. 8886
1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856
4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872
Interoperability endpoints
- djakins@direct.mhg.com
Organizations & group practices 6
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.
-
- Urology Physician
- Gulfport, MS
- NPI 1093142598
-
- Multi-Specialty Clinic/Center
- Diberville, MS
- NPI 1982148862
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1215546635
-
- Family Medicine Physician
- Gulfport, MS
- NPI 1619304185
-
- Emergency Medicine Physician
- Gulfport, MS
- NPI 1962780379
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
Hospital & facility affiliations 60
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Gulfport, MS
- NPI 1184956815
Hospital
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1215546635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364947200000",
"number": "1457543183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 SECURITY SQ",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395071932",
"telephone_number": "228-865-1330",
"fax_number": "228-865-1331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 SECURITY SQ",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395071932",
"telephone_number": "228-865-1330",
"fax_number": "228-865-1331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAKINS",
"first_name": "DIANE",
"middle_name": "C.",
"credential": "ACNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-16",
"last_updated": "2013-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MS",
"license": "R772563",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01282761",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.