Milestone Primary Care House Calls, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

MILESTONE PRIMARY CARE HOUSE CALLS, LLC

Practice address

5260 Cedar Park Dr Ste E
Jackson, MS 39206-4131

Phone

(601) 540-8260

NPI assigned

Sep 24, 2019

Organization subpart

No

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

Authorized official

Name

Cassandra Walters, FNP-C

Title

Owner

Phone

(601) 540-8260

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cassandra Amos- Johnson, FNP-C

  • Family Nurse Practitioner
  • Brookhaven, MS
  • NPI 1356856561
  NPD

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569283200000",
    "number": "1801447693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5260 CEDAR PARK DR STE E",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5260 CEDAR PARK DR STE E",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064131",
            "telephone_number": "601-540-8260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONE PRIMARY CARE HOUSE CALLS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-540-8260",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07935206",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elisa Miguel-Qin, MD
• Eleni Marie Mijalis
• Shannon Ayiesha Milbourne, M.D.
• Richard John Miles, DO
• Milestone Pediatric Medical Center
• Matthew Paul Miley, DO
• William Brent Miley, CRNA
• Millennial Healthcare, LLC
• Abigail Miller, LPC
• Ashley Miller, RN

• Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.