Jensen Ciacci, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1002 Jefferson Street
Ste 400
Laurel, MS 39440

Phone

(601) 649-7802

NPI assigned

Apr 15, 2024

Sex

Female

Sole proprietor

Yes

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

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Central Clinics, IncGroup PAC ID 4385876655, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Central Reg Med Ctr Hospital, Laurel, MS, CCN 250058

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• South Central Clinics, Inc

  • Family Medicine Physician
  • Ellisville, MS
  • NPI 1801226287

  MS

  Medicare reassignment Care Compare group
• South Central Clinics, Inc

  • Rural Health Clinic/Center
  • Laurel, MS
  • NPI 1033903547
  Care Compare group NPD
• South Central Clinics, Inc.

  • Rural Health Clinic/Center
  • Ellisville, MS
  • NPI 1427098003
  Care Compare group NPD (past)
• South Central Clinics, Inc

  • Rural Health Clinic/Center
  • Laurel, MS
  • NPI 1316975394
  Care Compare group
• South Central Clinics, Inc

  • Rural Health Clinic/Center
  • Laurel, MS
  • NPI 1669609111
  Care Compare group
• South Central Clinics, Inc

  • Rural Health Clinic/Center
  • Laurel, MS
  • NPI 1861037749
  Care Compare group
• South Central Cinics, Inc

  • Podiatrist
  • Laurel, MS
  • NPI 1598548042
  NPD
• South Central Clinics, Inc

  • Surgery Physician
  • Laurel, MS
  • NPI 1154405413
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Central Regional Medical Center

  • General Acute Care Hospital
  • Laurel, MS
  • NPI 1619973542

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1902650195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410247",
            "telephone_number": "601-425-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 JEFFERSON STREET",
            "address_2": "STE 400",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "39440",
            "telephone_number": "601-649-7802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "48751 Outpost Rd",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "OH",
            "postal_code": "437249491",
            "country_code": "US",
            "telephone_number": "740-509-0879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIACCI",
        "first_name": "JENSEN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl and Steve Inc.
• Childrens Specialty Clinic of Laurel
• Edmund Chinchar
• Brady J Church, DPT
• Carlee Windham Church
• Amanda Clark
• William G. Clark, M.D.
• Rushie Clayton, LCSW
• CLC of Laurel, LLC
• Jackie Coats, LSW

• All providers in Laurel, MS
• Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.