Jessica Bass
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Hattiesburg, MS
NPI 1558080739 · NPPES record last updated Feb 24, 2025
Key facts
- NPI
- 1558080739
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 887149 (MS)
- Practice address
- 2117 Broadway Drive
Hattiesburg, MS 39402-3210 - Phone
- (601) 288-8050
- Fax
- (601) 288-8058
- NPI assigned
- Aug 23, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 25
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Forrest County General Hospital
Practice addresses (Care Compare)
2117 Broadway Dr
Hattiesburg, MS 39402-3210
Phone (601) 288-8050
Hospital & facility affiliations
- Forrest General Hospital
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 |
|---|---|---|---|---|
| I20240626001195 | MS | Practitioner - Nurse Practitioner | 2769926229 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 821402 | MS | MD | Critical Care Medicine Registered Nurse |
| 887149 | MS | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forrest County General Hospital | Current |
Accepting new patients | |
| Forrest County General Hospital | Current |
Accepting new patients | |
| Forrest County General Hospital | Current | Accepting new patients |
Locations
2117 Broadway Dr
Hattiesburg, MS 39402
Phone (601) 288-8050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 887149 | MS | Yes |
| Critical Care Medicine Registered Nurse | 163WC0200X | 821402 | MS |
Addresses
Primary practice location
2117 Broadway Drive
Hattiesburg, MS 39402-3210
Mailing address
2117 Broadway Drive
Hattiesburg, MS 39402-3210
Phone (601) 288-8050
Other practice location 1
1 Lincoln Pkwy
Hattiesburg, MS 39402-3262
Phone (601) 288-8050
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | other | Other |
Other providers in Hattiesburg, MS
- Angela Nicole Barton
- Lori H. Bartran
- Barron Nicole Barzelay
- Venkatasubramanian Baskararajan
- Madison Canary Baskin
- Mary Jane Bass
- Meredith Bass
- Heather Pritchett Bassi
- Roopsi Bassi
- Amira Basyouny
All providers in Hattiesburg, 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 Feb 24, 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).
- 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.