Active NPI
Jackie Clanton McDonald, DNP-C
- Family Nurse Practitioner
- Madison, MS
National Provider Identifier
1831473552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R863322
- Practice address
- 10 Provence Blvd
Madison, MS 39110-8350 - Phone
- (601) 608-7213
- Fax
- (601) 608-7213
- NPI assigned
- Sep 29, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R863322 | MS | Primary |
Addresses
Primary practice location
10 Provence Blvd
Madison, MS 39110-8350
Mailing address
10 Provence Blvd
Madison, MS 39110-8350
Phone (601) 608-7213
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774828800000",
"number": "1831473552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 PROVENCE BLVD",
"city": "MADISON",
"state": "MS",
"postal_code": "391108350",
"telephone_number": "601-608-7213",
"fax_number": "601-608-7213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 PROVENCE BLVD",
"city": "MADISON",
"state": "MS",
"postal_code": "391108350",
"telephone_number": "601-608-7213",
"fax_number": "601-608-7213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "JACKIE",
"middle_name": "CLANTON",
"credential": "DNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-29",
"last_updated": "2026-03-30",
"certification_date": "2026-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R863322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.