Robert Josh Wansley, CFNP

Individual provider Active NPI Primary Care Nurse Practitioner · Laurel, MS

NPI 1821320201 · NPPES record last updated Nov 26, 2021

Key facts

NPI
1821320201
Entity type
Individual (NPI type 1)
Primary specialty
Primary Care Nurse Practitioner 363LP2300X
License
R867280 (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
Sex
Male
Sole proprietor
No

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 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jones Family Medicine Clinic PLLC (10 clinicians)

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Mississippi Homecare of Richton Home health agency · Richton, MS · CCN 257120
  • Deaconess Homecare- Region I Home health agency · Laurel, MS · CCN 257085
  • Adoration Home Health Home health agency · Collins, MS · CCN 257087
  • South Central Reg Med Ctr Hospital · Laurel, MS · CCN 250058

Merit-based Incentive Payment System (MIPS)

Final score
94.76 of 100 (group)
Quality
87.92
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110428000279 MS Practitioner - Nurse Practitioner 4789869140 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
No
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

Practice roles

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

Specialties & licenses

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

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 26, 2021.

{
    "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

All providers in Laurel, MS · Primary Care Nurse Practitioner in Mississippi

Sources for this page

Verify at the official NPI Registry.