Individual provider Active NPI

Jessica Marie Smith, MSN, FNP

  • Nurse Practitioner
  • Lucedale, MS
National Provider Identifier
1700550233
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
904825 Issued in MS
Practice address
92 Ratliff St Ste a
Lucedale, MS 39452-6537
Phone
(601) 947-8181
NPI assigned
Aug 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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 904825 MS Primary

Addresses

Primary practice location

92 Ratliff St Ste a
Lucedale, MS 39452-6537

Mailing address

92 Ratliff St Ste a
Lucedale, MS 39452-6537
Phone (601) 947-8181

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
I20210928000981 MS Practitioner - Nurse Practitioner 0941607303 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical CenterGroup PAC ID 8921072588, 17 clinicians

Practice addresses (Care Compare)

92 Ratliff St
Suite a
Lucedale, MS 39452-6537
Phone (601) 947-4411

Hospital & facility affiliations

  • George Regional Health System Hospital, Lucedale, MS, CCN 250036
  • Greene County Hospital Hospital, Leakesville, MS, CCN 250782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Center CurrentSince Sep 1, 2021 Accepting new patients
Wiggins Primary Care CurrentSince Sep 1, 2021 Accepting new patients
Inpatient Physician Services CurrentSince Sep 1, 2021 Accepting new patients
Greene County Family Medical Clinic CurrentSince Sep 1, 2021 Accepting new patients
George Regional ER Physicians CurrentSince Sep 1, 2021 Accepting new patients
George Regional Radiology PastSince Sep 1, 2021 Accepting new patients

Locations

1017 Jackson Ave
Leakesville, MS 39451
Phone (601) 394-2820

92 Ratliff St
#A
Lucedale, MS 39452
Phone (601) 947-4411

859 Winter St
Lucedale, MS 39452
Phone (601) 766-4286

975 Hall St
Wiggins, MS 39577
Phone (601) 528-9119

Interoperability endpoints

  • Direct secure messaging: jessicasmith@communitym.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/IBHCBA

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1628294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1700550233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 RATLIFF ST STE A",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394526537",
            "telephone_number": "601-947-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 RATLIFF ST STE A",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394526537",
            "telephone_number": "601-947-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-07",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "904825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lucedale, MS

Sources for this page

Verify at the official NPI Registry.