Jeffrey Ray Duckworth, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903057 Issued in MS

Practice address

104 Burney Dr
Flowood, MS 39232-6621

Phone

(601) 987-8200

NPI assigned

Dec 16, 2018

Last updated

Sep 8, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trustcare Health, LLCGroup PAC ID 0547427858, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19538/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/19538/brand/2/csg/1/fhir/r4
• Direct secure messaging: jeffrey.duckworth.1@19538.direct.athenahealth.com

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

• Trustcare Health, LLC

  dba Trust Care Health

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1427338235
  Medicare reassignment Care Compare group NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559

  Family

  Medicare reassignment NPD
• Gluckstadt TC Kids, LLC

  • Pediatrics Physician
  • Madison, MS
  • NPI 1255947297
  Medicare reassignment NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  NPD
• St. Dominic Jackson Memorial

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1235173691
  NPD (past)
• Trustcare Kids, LLC

  • Pediatrics Physician
  • Brandon, MS
  • NPI 1376321570
  NPD (past)
• Trustcare Primary Care, LLC

  dba TrustCare Health, LLC

  • Family Medicine Physician
  • Madison, MS
  • NPI 1174078554
  NPD (past)
• Advantage Health Saint Mary's Medical Group

  dba Trinity Health Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1952340911
  NPD (past)

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567900800000",
    "number": "1902377963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30594",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282300594",
            "telephone_number": "601-987-8200",
            "fax_number": "601-987-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BURNEY DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392326621",
            "telephone_number": "601-987-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWORTH",
        "first_name": "JEFFREY",
        "middle_name": "RAY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-16",
        "last_updated": "2019-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pierce D Dotherow, MD
• Seth Dean Dotherow, D.M.D.
• David E Doty
• Dr. George W. May, Jr., D.M.D
• Andrea Lynn Ducharme
• Andrew Wayne Duggar, DPT
• Michael G Dulske, M.D.
• Cindy Polk Dumas, PHARMD
• La'Trisha Dumas, LMT
• Jonathan Dunlap, DPC, LPC-S, BC-TMH

• Family Nurse Practitioner in Flowood, MS
• Providers in Flowood, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.