Individual provider Active NPI

Nelda Thomas, NP

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1801288410
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R783141 Issued in MS
Practice address
1850 Chadwick Dr
Jackson, MS 39204-3404
Phone
(706) 863-9595
Fax
(706) 868-8375
NPI assigned
Feb 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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 R783141 MS Primary

Addresses

Primary practice location

1850 Chadwick Dr
Jackson, MS 39204-3404

Mailing address

PO Box 3726
Augusta, GA 30914-3726
Phone (706) 863-9595

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
I20160201002118 MS Practitioner - Nurse Practitioner 6002110756 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mississippi Burn Hand and Reconstruction Centers PCGroup PAC ID 2163891268, 13 clinicians

Practice addresses (Care Compare)

1225 N State St
Jackson, MS 39202-2064
Phone (833) 672-8767

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Burn, Hand and Reconstruction Centers PC CurrentSince Dec 30, 2022 Accepting new patients
Fitness Clinic Wellness Family CurrentSince Aug 27, 2023 Accepting new patients

Locations

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

1225 N State St
Ste 103
Jackson, MS 39202
Phone (769) 268-6520

Organizations & group practices 2

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 1

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": "1424304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1801288410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3726",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309143726",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 CHADWICK DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043404",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "NELDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-19",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R783141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.