Individual provider Active NPI

Robert Josh Wansley, CFNP

  • Primary Care Nurse Practitioner
  • Laurel, MS
National Provider Identifier
1821320201
Registry record updated Nov 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R867280 Issued in MS
Practice address
30 Circle J Dr
Ste 1
Laurel, MS 39440-1980
Phone
(601) 425-0092
Fax
(601) 425-0473
NPI assigned
Feb 9, 2010
Last updated
Nov 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R867280 MS
Primary Care Nurse Practitioner 363LP2300X R867280 MS Primary

Addresses

Primary practice location

30 Circle J Dr
Ste 1
Laurel, MS 39440-1980

Mailing address

30 Circle J Dr
Ste 1
Laurel, MS 39440-1980
Phone (601) 425-0092

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
I20110428000279 MS Practitioner - Nurse Practitioner 4789869140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

30 Circle J Dr
Suite 1
Laurel, MS 39440-1981
Phone (601) 425-0092

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.76 of 100Reported as group
Quality
87.92
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R867280MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
JFMC Heidelberg, LLC CurrentSince Mar 23, 2011 Accepting new patients
Jones Family Medicine Clinic PLLC Current Accepting new patients
Jones Family Medicine Clinic, PLLC Past Accepting new patients

Locations

2680 Highway 15
Bay Springs, MS 39422
Phone (601) 764-6972

85 Hal Crocker Rd
Ellisville, MS 39437
Phone (601) 719-0092

1208 Academy Dr
Heidelberg, MS 39439
Phone (601) 787-4906

235 S 14th Ave
Laurel, MS 39440
Phone (601) 425-0092

235 S 14th Ave
#Q
Laurel, MS 39440
Phone (601) 651-2830

30 Circle J Dr
Ste 1
Laurel, MS 39440
Phone (601) 425-0092

Interoperability endpoints

  • Direct secure messaging: robertwansley@jfmc.ssdirect.aprima.com

Organizations & group practices 3

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 4

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": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637884800000",
    "number": "1821320201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CIRCLE J DR",
            "address_2": "STE 1",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401980",
            "telephone_number": "601-425-0092",
            "fax_number": "601-425-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CIRCLE J DR",
            "address_2": "STE 1",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401980",
            "telephone_number": "601-425-0092",
            "fax_number": "601-425-0473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANSLEY",
        "first_name": "ROBERT",
        "middle_name": "JOSH",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-09",
        "last_updated": "2021-11-26",
        "certification_date": "2021-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R867280",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "R867280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.