Brian Overstreet

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

R878670 Issued in MS

Practice address

2500 North State Street
Jackson, MS 39216-4500

Phone

(601) 984-5571

Fax

(601) 984-5583

NPI assigned

Jun 11, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS, TX2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acs Primary Care Physicians Southwest PAGroup PAC ID 1850204363, 188 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: boverstreet355579@ahs.direct-ci.com

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.

• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• App of Mississippi Ed, LLC

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1730687740
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment
• Camino Real Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Livingston, TX
  • NPI 1992871966

  Nurse Practitioner

  NPD (past)
• Texas Emergency Room Services PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1992843387
  NPD (past)

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

• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1568875151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5571",
            "fax_number": "601-984-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5571",
            "fax_number": "601-984-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERSTREET",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-11",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP136188",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "R878670",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "R878670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2408143",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05873296",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Our Family Home Hospice
• Ourtime Adult Day Care Services
• Out of the Box Therapy LLC
• Nicole Y Outlaw
• Rushton Overby, HIS
• Stacey Matthews Overstreet
• Jennifer Elizabeth Overton, ACNP
• John Stewart Overton
• Justice Owah
• Joseph Sam Owen Jr., M.D.

• Primary Care Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Primary Care Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.
• 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.