NPIMap

Individual provider Active NPI

Jennifer Robin Leggett-Hudson, NP

  • Family Nurse Practitioner
  • Mount Olive, MS
National Provider Identifier
1801100037
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F0610233 Issued in MS
Practice address
603 S Main St
Mount Olive, MS 39119-8902
Phone
(601) 797-3405
Fax
(601) 797-9482
NPI assigned
Jul 29, 2010
Last updated
Jul 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F0610233 MS Primary

Addresses

Primary practice location

603 S Main St
Mount Olive, MS 39119-8902

Mailing address

603 S Main St
Mount Olive, MS 39119-8902
Phone (601) 797-3405

Other identifiers 2

IdentifierTypeStateIssuer
07624895MedicaidMS
302I506890OtherMSMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101116000588 MS Practitioner - Nurse Practitioner 3476748427 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covington County HospitalGroup PAC ID 4183517253, shared by 16 NPIs, 44 clinicians
Magee Benevolent AssociationGroup PAC ID 3678466463, 19 clinicians

Practice addresses (Care Compare)

104 W Main St
20 Family Care Seminary
Seminary, MS 39479-9027
Phone (601) 722-3610

300 3Rd Ave SE
Magee, MS 39111-3665
Phone (601) 849-5070

300 3Rd Ave SE Northwing
Magee, MS 39111-3665
Phone (601) 849-7702

3275 Hwy 49 E
Family Care Express
Collins, MS 39428-3776
Phone (601) 765-6292

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F0610233MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covington County Hospital CurrentSince Jan 1, 2016 Accepting new patients
Covington County Hospital CurrentSince Jan 1, 2016 Accepting new patients
Magee Benevolent Association Family Current Accepting new patients
South Central Regional Medical Center CurrentSince Aug 7, 2023 Accepting new patients
Covington County Hospital Current Accepting new patients
South Central Regional Medical Center CurrentSince Aug 7, 2023 Accepting new patients
Green Tree Family Medical Clinic Current Accepting new patients
Paki Inc Past Accepting new patients

Locations

3275 Highway 49
Ste E
Collins, MS 39428
Phone (601) 765-6292

701 S Holly Ave
Collins, MS 39428
Phone (601) 765-3180

300 SE 3rd Ave
Magee, MS 39111
Phone (601) 849-5070

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1801100037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 S MAIN ST",
            "city": "MOUNT OLIVE",
            "state": "MS",
            "postal_code": "391198902",
            "telephone_number": "601-797-3405",
            "fax_number": "601-797-9482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S MAIN ST",
            "city": "MOUNT OLIVE",
            "state": "MS",
            "postal_code": "391198902",
            "telephone_number": "601-797-3405",
            "fax_number": "601-797-9482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGGETT-HUDSON",
        "first_name": "JENNIFER",
        "middle_name": "ROBIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-29",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "F0610233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07624895",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "302I506890",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Olive, MS

Sources for this page

Verify at the official NPI Registry.