Active NPI
Tonja Grines Hart, FNP
- Nurse Practitioner
- Jackson, MS
National Provider Identifier
1619255957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R852026
- Practice address
- 1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116 - Phone
- (601) 362-4471
- Fax
- (601) 364-1357
- NPI assigned
- Aug 3, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R852026 | MS | Primary |
Addresses
Primary practice location
1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116
Mailing address
1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116
Phone (601) 362-4471
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05484091 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R852026 | MS | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460592000000",
"number": "1619255957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 E WOODROW WILSON AVE",
"city": "JACKSON",
"state": "MS",
"postal_code": "392165116",
"telephone_number": "601-362-4471",
"fax_number": "601-364-1357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E WOODROW WILSON AVE",
"city": "JACKSON",
"state": "MS",
"postal_code": "392165116",
"telephone_number": "601-362-4471",
"fax_number": "601-364-1357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HART",
"first_name": "TONJA",
"middle_name": "GRINES",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-03",
"last_updated": "2016-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "R852026",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05484091",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.