Nashamba Jackson-Bracey, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F0815355 Issued in MS

Practice address

4490 Highway 80 E Ste a
Pearl, MS 39208-4213

Phone

(601) 337-8900

NPI assigned

Oct 18, 2016

Last updated

Apr 14, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Family Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pearl, MS
  • NPI 1043236326
  Medicare reassignment NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559

  Family

  Medicare reassignment NPD
• Family Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Tylertown, MS
  • NPI 1376776930
  NPD
• Family Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Flowood, MS
  • NPI 1689440133
  NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  NPD
• Providence Wellness, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Pearl, MS
  • NPI 1548076490

  Family

  NPD (past)

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555200000000",
    "number": "1558812263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4490 HIGHWAY 80 E STE A",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392084213",
            "telephone_number": "601-337-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4490 HIGHWAY 80 E STE A",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392084213",
            "telephone_number": "601-337-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON-BRACEY",
        "first_name": "NASHAMBA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-18",
        "last_updated": "2019-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "881624",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "F0815355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "1740742329",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aliesha Lanette Hudson
• Mario Hull
• Infusion Partners LLC (BioScrip Infusion Services)
• Infusion Partners, LLC (BioScrip Infusion Services)
• Robert W Inzer, M.D.
• Candace Jackson
• Tiffany Jackson, FNP-C
• Jacksonbracey Health Care
• Jessica Johnson, CPHT
• Joyce M Johnson, MN, RN, CFNP

• Family Nurse Practitioner in Pearl, MS
• Providers in Pearl, 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 Apr 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.