Individual provider Active NPI

Jazzma Trice, FNP

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1821585241
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902492 Issued in MS
Practice address
499 Gloster Creek VLG Ste G1
Tupelo, MS 38801-4751
Phone
(662) 377-2663
NPI assigned
Apr 20, 2018
Last updated
Dec 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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 902492 MS Primary
Registered Nurse First Assistant 163WR0006X 902492 MS

Addresses

Primary practice location

499 Gloster Creek VLG Ste G1
Tupelo, MS 38801-4751

Mailing address

4381 S Eason Blvd
Tupelo, MS 38801-6583

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
I20180619000740 MS Practitioner - Nurse Practitioner 0547515389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Institute of North Mississippi, LLCGroup PAC ID 7113914078, 10 clinicians

Practice addresses (Care Compare)

499 Gloster Creek VLG
Suite G1
Tupelo, MS 38801-4751
Phone (662) 377-2663

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Current Accepting new patients
Orthopaedic Institute of North Mississippi, LLC Sports Medicine CurrentSince May 21, 2018 Accepting new patients
North Mississippi Medical Center Services LLC Past Accepting new patients

Locations

4381 S Eason Blvd
Tupelo, MS 38801
Phone (662) 377-5199

4381 S Eason Blvd
Ste 303
Tupelo, MS 38801
Phone (662) 840-5747

499 Gloster Creek Vlg
Ste G1
Tupelo, MS 38801
Phone (662) 377-2663

Interoperability endpoints

  • Direct secure messaging: jazzmatrice@nmhs.medalliesdirect.net

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 1

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": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1821585241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4381 S EASON BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG STE G1",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014751",
            "telephone_number": "662-377-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRICE",
        "first_name": "JAZZMA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902492",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "MS",
            "license": "902492",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.