Individual provider Active NPI

Jason David Lowery, PA-C

  • Physician Assistant
  • Biloxi, MS
National Provider Identifier
1467471045
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00070 Issued in MS
Practice address
1720A Medical Park Dr
Suite 220
Biloxi, MS 39532-2129
Phone
(228) 392-9533
Fax
(228) 392-1781
NPI assigned
Jul 18, 2006
Last updated
Apr 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00070 MS Primary
Surgical Physician Assistant 363AS0400X PA00070 MS

Addresses

Primary practice location

1720A Medical Park Dr
Suite 220
Biloxi, MS 39532-2129

Mailing address

6300 E Lake Blvd
Ste. 301
Vancleave, MS 39565-6770
Phone (228) 230-2663

Other identifiers 1

IdentifierTypeStateIssuer
00534899MedicaidMS

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
I20051017000734 MS Practitioner - Physician Assistant 7618993965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1720 A Medical Park Dr
Suite 220
Biloxi, MS 39532-2127
Phone (228) 392-9355

6300 E Lake Blvd
Vancleave, MS 39565-6771
Phone (228) 230-2663

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00070MSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bienville Orthopaedic Specialists, LLC CurrentSince Jul 18, 2005 Accepting new patients

Locations

1720A Medical Park Dr
Ste 220
Biloxi, MS 39532
Phone (228) 392-9355

6300 E Lake Blvd
Ste 301
Vancleave, MS 39565

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1467471045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 E LAKE BLVD",
            "address_2": "STE. 301",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395656770",
            "telephone_number": "228-230-2663",
            "fax_number": "228-206-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720A MEDICAL PARK DR",
            "address_2": "SUITE 220",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322129",
            "telephone_number": "228-392-9533",
            "fax_number": "228-392-1781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWERY",
        "first_name": "JASON",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00070",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MS",
            "license": "PA00070",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00534899",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.