Jackie B Stuckey, CFNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R805328 Issued in MS

Practice address

62 Highway 587
Foxworth, MS 39483

Phone

(601) 424-3540

Fax

(601) 424-3544

NPI assigned

Jul 25, 2006

Last updated

Sep 27, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Practice roles

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.

• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  NPD (past)
• Forrest County General Hospital

  dba Marion General Rural Health Clinic

  • Rural Health Clinic/Center
  • Columbia, MS
  • NPI 1427457084
  NPD (past)
• South Mississippi Associate in Radiation Therapy, PLLC

  • Radiation Oncology Clinic/Center
  • Hattiesburg, MS
  • NPI 1114121373
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1689696627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 669",
            "city": "FOXWORTH",
            "state": "MS",
            "postal_code": "39483",
            "telephone_number": "601-424-3540",
            "fax_number": "601-424-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 HIGHWAY 587",
            "city": "FOXWORTH",
            "state": "MS",
            "postal_code": "39483",
            "telephone_number": "601-424-3540",
            "fax_number": "601-424-3544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "JACKIE",
        "middle_name": "B",
        "credential": "CFNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R805328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09372826",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Hope Schwartz, M.S. CCC-SLP
• David Dewayne Smith
• Sharon D. Stewart, SLP
• Cindy Stogner, M.S., CCC-SLP
• Lloyd Clifton Stringer, FNP
• Rachel Taggart, SLP
• Tender Love Care Personal Care (Tender Love Homecare)
• The Clinic at Farmers Medshoppe
• Katherine Ward
• Sharity Nicole Willis

• Nurse Practitioner in Foxworth, MS
• Providers in Foxworth, 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 27, 2013; 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.