Individual provider Active NPI

Constance McMillan Harthcock, FNP-C

  • Family Nurse Practitioner
  • Brandon, MS
National Provider Identifier
1841665494
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
730564 Issued in MS
Practice address
1297 W Government St
Brandon, MS 39042-3048
Phone
(601) 200-4790
Fax
(601) 200-4855
NPI assigned
Dec 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 730564 MS Primary

Addresses

Primary practice location

1297 W Government St
Brandon, MS 39042-3048

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (601) 200-4790

Other practice location 1

1887 Spillway Rd
Brandon, MS 39047-6066
Phone (601) 992-5532

Other practice location 2

610 Second St
Pelahatchie, MS 39145-3135
Phone (601) 200-4266

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
I20160425000738 MS Practitioner - Nurse Practitioner 2466751581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

106 Highland Way
Madison, MS 39110-6933

1297 W Government St
St Dominic Family Practice Associaties
Brandon, MS 39042-3048
Phone (601) 200-4790

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as apm
Quality
73.43
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
730564MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Dominic Medical Associates, LLC CurrentSince Oct 4, 2023 Accepting new patients
St Dominic Medical Associates LLC CurrentSince Oct 4, 2023 Accepting new patients
St. Dominic Medical Associates LLC Current Accepting new patients
Baptist Medical Center-Leake, Inc Past Accepting new patients
St Dominic Medical Associates LLC Family Past Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

1297 W Government St
Brandon, MS 39042
Phone (601) 200-4790

106 Highland Way
Ste 202
Madison, MS 39110
Phone (601) 200-3376

Interoperability endpoints

  • Direct secure messaging: charthcock5246570@direct.casso.us.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1449532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1841665494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "601-200-4790",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1297 W GOVERNMENT ST",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423048",
            "telephone_number": "601-200-4790",
            "fax_number": "601-200-4855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1887 Spillway Rd",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "MS",
            "postal_code": "390476066",
            "country_code": "US",
            "telephone_number": "601-992-5532",
            "fax_number": "601-992-5547",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "610 Second St",
            "address_purpose": "LOCATION",
            "city": "Pelahatchie",
            "state": "MS",
            "postal_code": "391453135",
            "country_code": "US",
            "telephone_number": "601-200-4266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTHCOCK",
        "first_name": "CONSTANCE",
        "middle_name": "MCMILLAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-08",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "730564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, MS

Sources for this page

Verify at the official NPI Registry.