Individual provider Active NPI

Jennifer Hart, NP

  • Family Nurse Practitioner
  • McComb, MS
National Provider Identifier
1821768672
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904768 Issued in MS
Practice address
300 Rawls Dr Ste 700
McComb, MS 39648-2877
Phone
(601) 250-4381
Fax
(601) 250-4382
NPI assigned
Sep 14, 2021
Last updated
Sep 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 904768 MS
Family Nurse Practitioner 363LF0000X 904768 MS Primary

Addresses

Primary practice location

300 Rawls Dr Ste 700
McComb, MS 39648-2877

Mailing address

PO Box 490
McComb, MS 39649-0490
Phone (601) 250-4366

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
I20210927001638 MS Practitioner - Nurse Practitioner 0446657944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 Marion Ave
McComb, MS 39648-2706
Phone (601) 250-4381

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Mississippi Regional Medical Center CurrentSince Sep 24, 2024 Accepting new patients
Southwest Mississippi Regional Medical Center Current Accepting new patients

Locations

200 Marion Ave
McComb, MS 39648
Phone (601) 250-4381

215 Marion Ave
McComb, MS 39648
Phone (601) 249-1180

300 Rawls Dr
Ste 200
McComb, MS 39648
Phone (601) 249-1570

300 Rawls Dr
Ste 700
McComb, MS 39648
Phone (601) 250-4381

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1821768672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-250-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RAWLS DR STE 700",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482877",
            "telephone_number": "601-250-4381",
            "fax_number": "601-250-4382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "904768",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.