Individual provider Active NPI

Pamelia Watson-McGee, CFNP

  • Pediatric Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1922042407
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R749442 Issued in MS
Practice address
3502 W Northside Dr
Jackson, MS 39213-4454
Phone
(601) 362-5321
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R749442 MS Primary

Addresses

Primary practice location

3502 W Northside Dr
Jackson, MS 39213-4454

Mailing address

3502 W Northside Dr
Jackson, MS 39213-4454
Phone (601) 362-5321

Other identifiers 1

IdentifierTypeStateIssuer
00115994MedicaidMS

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
I20080924000324 MS Practitioner - Nurse Practitioner 5395812911 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Mississippi Civic Improvement Association, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Central Mississippi Civic Improvement Association, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Central Mississippi Civic Improvement Association, Inc Current Accepting new patients

Locations

3502 W Northside Dr
Unit 5
Jackson, MS 39213

1850 Chadwick Dr
Jackson, MS 39204
Phone (601) 376-1000

3502 W Northside Dr
Jackson, MS 39213
Phone (601) 982-1625

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

129 White Oak St
Utica, MS 39175
Phone (601) 885-6021

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309478400000",
    "number": "1922042407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON-MCGEE",
        "first_name": "PAMELIA",
        "name_prefix": "Ms.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2011-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "R749442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115994",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.