Individual provider Active NPI

Jill Taylor Easley

  • Family Nurse Practitioner
  • Madison, MS
National Provider Identifier
1891100970
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R877394 Issued in MS
Practice address
106 Highland Way
Suite 103
Madison, MS 39110-6929
Phone
(601) 200-4750
Fax
(601) 200-4740
NPI assigned
Jun 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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 R877394 MS Primary

Addresses

Primary practice location

106 Highland Way
Suite 103
Madison, MS 39110-6929

Mailing address

PO Box 23666
Jackson, MS 39225-3666
Phone (601) 200-4749

Other practice location 1

286 Calhoun Station Pkwy
Madison, MS 39110-5537
Phone (601) 200-4321

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
I20140924000240 MS Practitioner - Nurse Practitioner 4688893613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
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

106 Highland Way
Suite 103 St Dominic Family Practice Madis
Madison, MS 39110-6930
Phone (601) 200-4750

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
R877394MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Dominic Medical Associates LLC CurrentSince Jul 1, 2014 Accepting new patients
St. Dominic Medical Associates LLC CurrentSince Jul 1, 2014 Accepting new patients
St Dominic Medical Associates LLC Family Past Accepting new patients
St. Dominic Medical Associates LLC Past Accepting new patients

Locations

106 Highland Way
Ste 103
Madison, MS 39110
Phone (601) 200-4750

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

Interoperability endpoints

  • Direct secure messaging: jeasley2546026@direct.casso.us.com

Organizations & group practices 4

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 3

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": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1891100970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23666",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253666",
            "telephone_number": "601-200-4749",
            "fax_number": "601-200-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 HIGHLAND WAY",
            "address_2": "SUITE 103",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106929",
            "telephone_number": "601-200-4750",
            "fax_number": "601-200-4740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "286 Calhoun Station Pkwy",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "MS",
            "postal_code": "391105537",
            "country_code": "US",
            "telephone_number": "601-200-4321",
            "fax_number": "601-859-0159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EASLEY",
        "first_name": "JILL",
        "middle_name": "TAYLOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R877394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

Verify at the official NPI Registry.