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
Hospital & facility affiliations 4
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
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
- Deaconess Homecare- Region I
- Adoration Home Health
- South Central Reg Med Ctr
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.76 of 100
- 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JFMC Heidelberg, LLC | Current |
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
- robertwansley@jfmc.ssdirect.aprima.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
{
"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
- Elizabeth Cori Walters
- Fred Irvin Walters Jr.
- Robert William Walters
- Spring Kimberly Walters
- Vernesa Kaye Walters
- Ashley Warren
- Norrapol Wattanasuwan
- Martha Laurie Watts
- Shannon Creel Weathers
- Khaleah Alexandria Weathersby
All providers in Laurel, MS · Primary Care Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.