Individual provider Active NPI

Jessica Breland, RD

  • Registered Dietitian
  • Hattiesburg, MS
National Provider Identifier
1538799275
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
D1837 Issued in MS
Practice address
6414 Highway 98 West
Suite 120
Hattiesburg, MS 39402
Phone
(601) 296-2833
Fax
(601) 261-5175
NPI assigned
Jan 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X D1837
Registered Dietitian 133V00000X D1837 MS Primary

Addresses

Primary practice location

6414 Highway 98 West
Suite 120
Hattiesburg, MS 39402

Mailing address

74 Cedar Grove Rd
Petal, MS 39465-5201
Phone (601) 543-3392

Other identifiers 1

IdentifierTypeStateIssuer
06477724MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbreland95541@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200311000590 MS Practitioner - Registered Dietitian Or Nutrition Professional 1759719420 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D1837MSMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic PA CurrentSince Feb 24, 2020 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Feb 24, 2020 Accepting new patients

Locations

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

Interoperability endpoints

  • Direct secure messaging: jbreland95541@directpatientrecord.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1538799275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 CEDAR GROVE RD",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394655201",
            "telephone_number": "601-543-3392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6414 HIGHWAY 98 WEST",
            "address_2": "SUITE 120",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-296-2833",
            "fax_number": "601-261-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRELAND",
        "first_name": "JESSICA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": "D1837",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MS",
            "license": "D1837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06477724",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbreland95541@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "6414 Highway 98 West",
            "address_2": "Suite 120",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "39402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.