Individual provider Active NPI

Jason Jackson Heywood

  • Peer Specialist
  • Pascagoula, MS
National Provider Identifier
1700650538
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
4905 Telephone Rd
Pascagoula, MS 39567-1823
Phone
(228) 769-1280
NPI assigned
Nov 13, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

4905 Telephone Rd
Pascagoula, MS 39567-1823

Mailing address

3407 Shamrock CT
Gautier, MS 39553-5337
Phone (228) 497-0690

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1700650538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 SHAMROCK CT",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535337",
            "telephone_number": "228-497-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 TELEPHONE RD",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395671823",
            "telephone_number": "228-769-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYWOOD",
        "first_name": "JASON",
        "middle_name": "JACKSON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.