Matthew Edward Flynn, FNP, ACNP
Individual provider Active NPI Acute Care Nurse Practitioner · Jackson, MS
NPI 1760618292 · NPPES record last updated Oct 10, 2012
Key facts
- NPI
- 1760618292
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- R860587 (MS)
- Practice address
- 971 Lakeland Dr Ste 1052
Jackson, MS 39216-4609 - Phone
- (601) 981-9503
- Fax
- (601) 982-1198
- NPI assigned
- Jun 10, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Jackson Pulmonary Associates, PA
Practice addresses (Care Compare)
971 Lakeland Dr
Suite 1052
Jackson, MS 39216-4609
Phone (601) 981-9503
Hospital & facility affiliations
- Mississippi Baptist Medical Center
- Simpson General Hospital Cah
- St Dominic-Jackson Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090929000516 | MS | Practitioner - Nurse Practitioner | 5698811982 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pearl River County Hospital | Current |
Accepting new patients | |
| Forrest County General Hospital | Current |
Accepting new patients | |
| Independent Healthcare Management, Inc. | Current |
Accepting new patients | |
| Forrest County General Hospital | Current |
Accepting new patients | |
| Simpson Community Healthcare, Inc | Current |
Accepting new patients | |
| Independent Healthcare Management, Inc. | Current |
Accepting new patients | |
| Jackson Pulmonary Associates, PA | Current |
Accepting new patients | |
| Forrest County General Hospital | Current | Accepting new patients | |
| Simpson Community Healthcare Inc. | Current |
Accepting new patients | |
| Simpson Community Healthcare, Inc. | Current | Accepting new patients | |
| Forrest County General Hospital | Current |
Accepting new patients | |
| Gulfport Emergency Physicians | Past | Accepting new patients |
Locations
330 N Broad St
Forest, MS 39074
Phone (601) 469-4151
330 N Broad St
#S
Forest, MS 39074
Phone (601) 469-4151
6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690
971 Lakeland Dr
Ste 1052
Jackson, MS 39216
Phone (601) 981-9503
501 Marshall St
Ste 200
Jackson, MS 39202
Phone (601) 354-8895
1842 Simpson Highway 149
Mendenhall, MS 39114
Phone (601) 847-2221
305 W Moody St
Poplarville, MS 39470
Phone (601) 795-4345
305 W Moody St
#H
Poplarville, MS 39470
Phone (601) 795-4345
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.323
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | R860587 | MS | Yes |
| Family Nurse Practitioner | 363LF0000X | R860587 | MS |
Addresses
Primary practice location
971 Lakeland Dr Ste 1052
Jackson, MS 39216-4609
Mailing address
971 Lakeland Dr Ste 1052
Jackson, MS 39216-4609
Phone (601) 981-9503
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05156038 | Medicaid | MS | |
| 7885550 | Other | MS | CIGNA |
| P00775214 | Other | MS | RAILROAD MEDICARE |
Other providers in Jackson, MS
- Jamie Cummings Floyd
- John David Floyd
- Lakeisha Yvette Floyd
- Tiffany Floyd
- James D Fly
- Joel Ray Flynt
- Bridget Foley
- Michael Folkes
- Jacob M Folse
- Cydney Fondel
All providers in Jackson, MS · Acute Care Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.