Jeffery Chancellor, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Meridian, MS
NPI 1841047271 · NPPES record last updated Mar 26, 2025
Key facts
- NPI
- 1841047271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 906509 (MS)
- Practice address
- 1415 College Dr
Meridian, MS 39307-5345 - Phone
- (601) 483-4821
- NPI assigned
- May 3, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Region Ten State of Ms
Practice addresses (Care Compare)
1415 College Dr
Meridian, MS 39307-5345
Phone 6014834821125
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 |
|---|---|---|---|---|
| I20250516001962 | MS | Practitioner - Nurse Practitioner | 4183142821 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 906509 | MS | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Region Ten Commission State of Ms | Current |
Accepting new patients |
Locations
1415 College Dr
Meridian, MS 39307
Phone (601) 483-4821
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 906509 | MS | Yes |
Addresses
Primary practice location
1415 College Dr
Meridian, MS 39307-5345
Mailing address
PO Box 2868
Meridian, MS 39302-2868
Phone (601) 483-4821
Other providers in Meridian, MS
- Centered Chiropractic and Wellness
- Centerwell Certified Healthcare Corp.
- Felicia Chamberlin
- Tashanda Chamberlin
- Andrew Daughton Chambers
- Christa Bren Chandler
- Rebecca Faye Chaney
- Tim James Chapin
- Johnnie Chapman
- Rachel S Chard
All providers in Meridian, MS · Psychiatric/Mental Health 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 Mar 26, 2025. 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.