Individual provider Active NPI

Jenny Taylor, FNP-BC

  • Family Nurse Practitioner
  • Grenada, MS
National Provider Identifier
1669971180
Registry record updated Feb 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902271 Issued in MS
Practice address
350 Sunset Drive
Grenada, MS 38901
Phone
(662) 307-2750
NPI assigned
Feb 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 902271 MS Primary

Addresses

Primary practice location

350 Sunset Drive
Grenada, MS 38901

Mailing address

3329 Attala Road 2247
Kosciusko, MS 39090
Phone (662) 633-2032

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
I20180327000139 MS Practitioner - Nurse Practitioner 2567724859 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ms State Department of HealthGroup PAC ID 0244129245, 21 clinicians

Practice addresses (Care Compare)

570 E Woodrow Wilson Ave
Jackson, MS 39216-4538
Phone (601) 576-7345

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ms State Department of Health CurrentSince Feb 16, 2022 Accepting new patients
Mississippi State Department of Health Current Accepting new patients
Family Health Care Clinic, Inc. CurrentSince Nov 19, 2018 Accepting new patients
Family Health Care Clinic, Inc. Current Accepting new patients
Ms State Dept of Health CurrentSince Feb 16, 2022 Accepting new patients
Quick Care Clinic LLC CurrentSince Feb 14, 2018 Accepting new patients
Family Health Care Clinic, Inc CurrentSince Nov 19, 2018 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Dec 4, 2020 Accepting new patients
C and K Pharmacy PastSince Sep 5, 2021 Accepting new patients

Locations

290 Highway 51 N
Brookhaven, MS 39601
Phone (601) 823-1710

1401 River Rd
Greenwood, MS 38930
Phone (662) 459-2603

350 Sunset Dr
Grenada, MS 38901
Phone (662) 307-2221

570 E Woodrow Wilson Ave
Jackson, MS 39216
Phone (601) 576-7345

4635 Highway 80 E
Pearl, MS 39208
Phone (601) 933-2500

123 N Front St
Winona, MS 38967
Phone (662) 283-1801

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1518220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518220800000",
    "number": "1669971180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3329 ATTALA ROAD 2247",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "39090",
            "telephone_number": "662-633-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SUNSET DRIVE",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "38901",
            "telephone_number": "662-307-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JENNY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-10",
        "last_updated": "2018-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grenada, MS

Sources for this page

Verify at the official NPI Registry.