Jason S. Box, CRNP
Individual provider Active NPI Nurse Practitioner · Leakesville, MS
NPI 1851448906 · NPPES record last updated Jan 13, 2011
Key facts
- NPI
- 1851448906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- R875627 (MS)
- Practice address
- 1017 Jackson Ave
Leakesville, MS 39451-9105 - Phone
- (601) 394-2820
- Fax
- (601) 394-2748
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Greene County Family Medical Clinic
Community Medical Center
Practice addresses (Care Compare)
1017 Jackson Ave
Leakesville, MS 39451-9105
Phone (601) 394-2820
92 Ratliff St
Suite a
Lucedale, MS 39452-6537
Phone (601) 947-4411
Hospital & facility affiliations
- Deaconess Homecare- Region I
- Enhabit Home Health of the Gulf Coast
- Greene County Hospital
- George Regional Health System
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 |
|---|---|---|---|---|
| I20070606000437 | MS | Practitioner - Nurse Practitioner | 7719085273 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| George County Hospital | Current | Accepting new patients | |
| Greene County Family Medical Clinic | Current |
Accepting new patients | |
| Inpatient Physician Services | Past | Accepting new patients | |
| Community Medical Center | Past | Accepting new patients |
Locations
1017 Jackson Ave
Leakesville, MS 39451
Phone (601) 394-2820
Interoperability endpoints
- jasonbox@communitym.allscriptsdirect.net
- jasonbox@grh.medalliesdirect.net
- https://fhir4.healow.com/fhir/r4/IBHCBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R875627 | MS | Yes |
Addresses
Primary practice location
1017 Jackson Ave
Leakesville, MS 39451-9105
Mailing address
PO Box 1007
Lucedale, MS 39452-1007
Phone (601) 947-1332
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00027266 | Medicaid | MS |
Other providers in Leakesville, MS
- Kimberly Allen
- Sherrill Hope Backstrom
- Bethany Ballenger
- Madison Bohannon
- Choice Primary Healthcare PLLC
- Coastal Family Health Center Inc
- Coastal Family Health Center Inc
- Coastal Family Health Center Inc
- Coastal Family Health Center, Inc
All providers in Leakesville, MS · 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 Jan 13, 2011. 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.