Jennifer Henley, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903852 Issued in MS

Practice address

3502 W Northside Dr
Jackson, MS 39213-4454

Phone

(601) 362-5321

NPI assigned

Jan 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

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.

• Central Mississippi Civic Improvement Association, Inc

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1134151442
  Medicare reassignment NPD
• Central Mississippi Civic Improvement Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1215744396
  NPD
• Central Mississippi Civic Improvement Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1427377266
  NPD

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1578037172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3437",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392073437",
            "telephone_number": "601-362-5321",
            "fax_number": "601-364-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10009 N MacArthur Blvd Ste 109",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750635082",
            "country_code": "US",
            "telephone_number": "214-812-9603",
            "fax_number": "214-812-9572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENLEY",
        "first_name": "JENNIFER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "AP140103",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Godfrey Hendon, MA, MS, CGC
• Kaitlyn W Hendrix, PHARMD
• Matthew English Hendry
• John Clark Henegan Jr., M.D.
• Aftan Henley, PHARMD
• Brian Allen Henry, LPTA
• Cinder Henry
• Craig Damon Henry, MSN, APRN, FNP-C
• David Chan Henry, MD
• Elizabeth Castleberry Henry, CRNFA

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, 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 May 5, 2020; 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.