Individual provider Active NPI

Joseph P Fero, NP

  • Nurse Practitioner
  • Vancleave, MS
National Provider Identifier
1669457925
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R588067 Issued in MS
Practice address
12313 Highway 57
Vancleave, MS 39565-9501
Phone
(228) 826-1990
Fax
(228) 826-1998
NPI assigned
Dec 9, 2005
Last updated
Oct 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R588067 MS Primary

Addresses

Primary practice location

12313 Highway 57
Vancleave, MS 39565-9501

Mailing address

12313 Highway 57
Vancleave, MS 39565-9501
Phone (228) 826-1990

Other identifiers 2

IdentifierTypeStateIssuer
02128275MedicaidMS
84-1670761OtherTAX ID #

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140623000436 MS Practitioner - Nurse Practitioner 8628014610 Practice locations: Vancleave, MS

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R588067MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Mississippi, LLC PastSince Oct 17, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413417600000",
    "number": "1669457925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12313 HIGHWAY 57",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395659501",
            "telephone_number": "228-826-1990",
            "fax_number": "228-826-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12313 HIGHWAY 57",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395659501",
            "telephone_number": "228-826-1990",
            "fax_number": "228-826-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERO",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2014-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R588067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02128275",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "84-1670761",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancleave, MS

Sources for this page

Verify at the official NPI Registry.