J Fails, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

J FAILS, LLC

Doing business as

Lucedale Pediatrics

Practice address

2210 Mill Street Ext Ste D
Lucedale, MS 39452-6079

Phone

(601) 953-3433

NPI assigned

Jan 11, 2021

Organization subpart

No

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

Authorized official

Name

Jennifer Fails, NP-C

Title

Owner

Phone

(601) 953-3433

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lucedale Pediatrics Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

J Fails LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• J Fails, LLC

  • General Practice Physician
  • Vancleave, MS
  • NPI 1780545103
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jasmini Neena Bowen, FNP

  • Family Nurse Practitioner
  • Lucedale, MS
  • NPI 1184325797
  NPD
• Jennifer Marie Redmond, NP

  • Family Nurse Practitioner
  • Lucedale, MS
  • NPI 1447261649
  NPD
• Tara Leann Tillman, FNP

  • Family Nurse Practitioner
  • Lucedale, MS
  • NPI 1245129030
  NPD (past)
• Melanie Brooke Parker, CRNP

  • Pediatric Nurse Practitioner
  • Mobile, AL
  • NPI 1063103596
  NPD (past)

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1851980379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 WELLINGTON WAY",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390478362",
            "telephone_number": "601-953-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 MILL STREET EXT STE D",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394526079",
            "telephone_number": "601-953-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J FAILS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "FAILS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-953-3433",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06852827",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lucedale Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James M Hunt, PT
• Deborah A Hyatt, CRNP
• Lacy Kaye Hyatt
• Inkind Mind Inc
• Inpatient Physician Services
• Brenda Janz-Hoover, PT
• Jims Discount Drugs Inc
• John T Dressler
• Kesha Brown Johnson, RN,BSN
• Jones County Medical Supplies, Inc

• Primary Care Clinic/Center in Lucedale, MS
• Providers in Lucedale, MS by specialty
• Primary Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.