Andrea Michele Jackson

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

902906 Issued in MS

Practice address

100 Wilburn Way
Starkville, MS 39759-3692

Phone

(662) 320-4008

NPI assigned

Sep 11, 2018

Last updated

Sep 11, 2018By 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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ajackson@redhillsortho.emadirect.md

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.

• Fast Pace Mississippi, PLLC

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

  Nurse Practitioner

  Medicare reassignment NPD
• Waldrop Chiropractic and Wellness, PLLC

  • Chiropractor
  • Starkville, MS
  • NPI 1033420328
  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  MS, Nurse Practitioner

  Medicare reassignment NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  NPD
• Golden Triangle Physical Therapy Inc.

  • Physical Therapist
  • Louisville, MS
  • NPI 1235154048
  NPD

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1568945947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILBURN WAY",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397593692",
            "telephone_number": "662-320-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WILBURN WAY",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397593692",
            "telephone_number": "662-320-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANDREA",
        "middle_name": "MICHELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "902906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron S. Huxford, M.D.
• Mary Paige Huxford, D.M.D.
• Imaging Centers for Excellence, LLC (Premier Imaging)
• Taylor Kathryn Irby, COTA/L
• Ernestine Ivy, NP
• Ruby J Jackson
• James S. Brown, III, M. D. PLLC
• Karla Y Jamison
• Jennifer Jennings, MS
• Letitia Ann Jensen Crawford, PH.D., LCSW

• Nurse Practitioner in Starkville, MS
• Providers in Starkville, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.