Jennifer Brooke Edwards, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R875038 Issued in MS

Practice address

136 Marion Ave
McComb, MS 39648-3620

Phone

(601) 684-3210

Fax

(601) 684-3319

NPI assigned

Sep 29, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brookhaven Ear, Nose and Throat PAGroup PAC ID 5092809764, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Brookhaven Ear, Nose & Throat PA

  • Otolaryngology Physician
  • Brookhaven, MS
  • NPI 1225152580
  Medicare reassignment Care Compare group NPD
• Soine Medical Enterprises, LLC

  • Dermatology Physician
  • Covington, LA
  • NPI 1871928051
  NPD
• Peak Healthcare

  • Family Nurse Practitioner
  • Summit, MS
  • NPI 1881845444
  NPD (past)

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

• King'S Daughters Medical Center

  • General Acute Care Hospital
  • Brookhaven, MS
  • NPI 1972503464
  Care Compare affiliation

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1790019354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483620",
            "telephone_number": "601-684-3210",
            "fax_number": "601-684-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483620",
            "telephone_number": "601-684-3210",
            "fax_number": "601-684-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JENNIFER",
        "middle_name": "BROOKE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R875038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anyana Dunmore
• Danielle Durr
• Curtis Ralph Dykes, RPH
• Kelly Edmondson, PTA
• Willie Edward
• Habib Elghoul, MD
• Misty Ellerby-Broussard
• James Stephen Ellis, PH.D.
• Embracing Hearts Healthcare
• Embracing Hearts Healthcare

• Family Nurse Practitioner in McComb, MS
• Providers in McComb, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.