Brandi Davis Johnston, NURSE PRACTITIONER
Individual provider Active NPI Adult Health Nurse Practitioner · Jackson, MS
NPI 1497271415 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1497271415
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 902163 (MS)
- Practice address
- 1200 North State Street
Suite 420
Jackson, MS 39202 - Phone
- (601) 355-3353
- NPI assigned
- Aug 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Medical Foundation of Central Mississippi Inc
Minor Med Care, LLC
MDB Behavioral Health Services LLC
Practice addresses (Care Compare)
1151 N State St
Suite 404
Jackson, MS 39202-2457
Phone (601) 292-4261
120 W Main St
Raymond, MS 39154-1223
Phone (601) 857-2341
1200 N State St
Jackson, MS 39202-2027
1225 N State St
Jackson, MS 39202-2064
Phone (601) 292-4261
1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598
401 Baptist Dr
Suite 104
Madison, MS 39110-2010
Phone (601) 973-1504
Hospital & facility affiliations
- Mississippi Baptist Medical Center
- Mississippi Methodist Rehab Ctr
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.38 of 100
- Quality
- 54.22
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.72
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 |
|---|---|---|---|---|
| I20171025002226 | MS | Practitioner - Nurse Practitioner | 9739455460 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 902163 | MS | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MDB Behavioral Health Services LLC | Current |
Accepting new patients | |
| Medical Foundation of Central Ms | Current |
Accepting new patients | |
| Minor Med Care, LLC | Current |
Accepting new patients | |
| Segue Health of Mississippi LLC | Current |
Accepting new patients | |
| MDB Care Management LLC | Primary Care | Current |
Accepting new patients |
| Medical Foundation of Central Mississippi, Inc. | Current |
Accepting new patients | |
| Minor Med Care, LLC | Current | Accepting new patients | |
| Uppal Medical Center LLC | Current |
Accepting new patients |
Locations
1727 E Union St
Greenville, MS 38703
Phone (662) 332-0373
2860 McDowell Road Ext
Jackson, MS 39204
Phone (601) 372-1117
1200 N State St
Ste 420
Jackson, MS 39202
Phone (601) 355-3353
215 Katherine Dr
#A
Jackson, MS 39232
1200 N State St
Ste 270
Jackson, MS 39202
Phone (601) 714-6470
1200 N State St
Ste 500
Jackson, MS 39202
Phone (601) 352-2273
1225 N State St
Jackson, MS 39202
Phone (601) 292-4261
401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383
965 Ridge Lake Blvd
Ste 103
Memphis, TN 38120
Phone (901) 227-3221
Interoperability endpoints
- bjohnston153454@direct.bmhcc.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 902163 | MS | |
| Primary Care Nurse Practitioner | 363LP2300X | 902163 | MS | |
| Adult Health Nurse Practitioner | 363LA2200X | 902163 | MS | Yes |
Addresses
Primary practice location
1200 North State Street
Suite 420
Jackson, MS 39202
Mailing address
965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446
Phone (901) 227-3255
Other practice location 1
1225 N State St
Jackson, MS 39202-2064
Phone (601) 968-1000
Other practice location 2
1225 N State St
Jackson, MS 39202-2064
Phone (601) 968-1000
Other practice location 3
1200 North State Street
Suite 420
Jackson, MS 39202
Phone (601) 355-3353
Other providers in Jackson, MS
- Warren Johnson
- Wayne C Johnson Jr.
- William Blair Johnson Jr.
- William Walter Johnson
- Andy Johnston
- Erin A Johnston
- James H Johnston
- William Andrew Johnston
- Abbie Joiner
- Dawn Taylor Joiner
All providers in Jackson, MS · Adult 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 Mar 17, 2018. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.