Jacqueline Suszan Ware, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R853566 Issued in MS

Practice address

2901 Highway 82 E
Greenwood, MS 38930-2960

Phone

(662) 374-2135

Fax

(662) 374-2195

NPI assigned

Oct 4, 2010

Last updated

Aug 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Golden Age IncGroup PAC ID 0941294292, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Greenwood Leflore Hospital Hospital, Greenwood, MS, CCN 250099

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Golden Age Inc

  dba Golden Age Clinic

  • Rural Health Clinic/Center
  • Greenwood, MS
  • NPI 1558693671

  W-2 Managing Employee

  CMS ownership

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.

• Golden Age Inc

  dba Golden Age Clinic

  • Rural Health Clinic/Center
  • Greenwood, MS
  • NPI 1558693671
  Medicare reassignment Care Compare group NPD
• Family Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pearl, MS
  • NPI 1043236326
  Medicare reassignment NPD
• Family Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pelahatchie, MS
  • NPI 1467478743
  NPD

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

• State of Mississippi - University of Mississippi Medical Center

  dba UMMC Greenwood Hospital

  • General Acute Care Hospital
  • Greenwood, MS
  • NPI 1699714717
  Care Compare affiliation

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1558670869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 HIGHWAY 82 E",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389302960",
            "telephone_number": "662-374-2135",
            "fax_number": "601-374-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 HIGHWAY 82 E",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389302960",
            "telephone_number": "662-374-2135",
            "fax_number": "662-374-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARE",
        "first_name": "JACQUELINE",
        "middle_name": "SUSZAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R853566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01044475",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08327741",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Huff Walker III, NBCOT
• Robert Christopher Walker, PT, DPT
• Cyneiceya Annette Wallace, MSN, APRN, AGPCNP-BC
• Walnut Creek Emergency Group, LLC
• Walnut Creek Physician Services, LLC
• Mildred B Ware, LPC
• Janice Watkins
• We Care Adult Day Care Cente4R
• We Come 2U Lab
• George Weathers, CRNA

• Family Nurse Practitioner in Greenwood, MS
• Providers in Greenwood, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.

Verify at the official NPI Registry.