Active NPI
John Christopher Funkhouser, N.P.
- Family Nurse Practitioner
- Madison, MS
National Provider Identifier
1821292046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R859048
- Practice address
- 286 Calhoun Station Parkway
Madison, MS 39110 - Phone
- (601) 200-4321
- Fax
- (601) 859-0159
- NPI assigned
- Jun 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R859048 | MS | Primary |
Addresses
Primary practice location
286 Calhoun Station Parkway
Madison, MS 39110
Mailing address
PO Box 23666
Jackson, MS 39225-3666
Phone (601) 200-4749
Other practice location 1
971 Lakeland Dr
Suite 250
Jackson, MS 39216-4643
Phone (601) 200-4860
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02300532 | Medicaid | MS | |
| P00739236 | Other | RAILROAD MEDICARE |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070829000572 | MS | Practitioner - Nurse Practitioner | 3678666195 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
106 Highland Way
Madison, MS 39110-6933
Hospital & facility affiliations
- Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson
- Centerwell Home Health
- St Dominic-Jackson Memorial Hospital
- Mississippi Methodist Rehab Ctr
- Mississippi Baptist Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.09 of 100
- Quality
- 73.43
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R859048 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Dominic Medical Associates LLC | Current | Accepting new patients | |
| St Dominic Medical Associates LLC | Current | Accepting new patients | |
| St Dominic Medical Associates LLC | Family | Past | Accepting new patients |
| St. Dominic Medical Associates LLC | Past | Accepting new patients |
Locations
971 Lakeland Dr
Ste 250
Jackson, MS 39216
Phone (601) 200-4860
106 Highland Way
Ste 202
Madison, MS 39110
Phone (601) 200-3376
Interoperability endpoints
- jfunkhouser2546028@direct.casso.us.com
Organizations & group practices 4
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.
-
- Hospitalist Physician
- Jackson, MS
- NPI 1285987578
-
- Family Medicine Physician
- Madison, MS
- NPI 1245393255
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Flowood, MS
- NPI 1417935578
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1710909585
Hospital
-
- Durable Medical Equipment & Medical Supplies
- Tupelo, MS
- NPI 1205604071
Hospital
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1841349792
Hospital
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1306876065
Hospital
-
- Home Health Agency
- Clinton, MS
- NPI 1356482749
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566432000000",
"number": "1821292046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23666",
"city": "JACKSON",
"state": "MS",
"postal_code": "392253666",
"telephone_number": "601-200-4749",
"fax_number": "601-200-5929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "286 CALHOUN STATION PARKWAY",
"city": "MADISON",
"state": "MS",
"postal_code": "39110",
"telephone_number": "601-200-4321",
"fax_number": "601-859-0159"
}
],
"practiceLocations": [
{
"address_1": "971 Lakeland Dr",
"address_2": "Suite 250",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "MS",
"postal_code": "392164643",
"country_code": "US",
"telephone_number": "601-200-4860",
"fax_number": "601-200-4887",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FUNKHOUSER",
"first_name": "JOHN",
"middle_name": "CHRISTOPHER",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-12",
"last_updated": "2019-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R859048",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02300532",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00739236",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.