Individual provider Active NPI

Jennifer H Stone, PA

  • Dermatology Physician
  • Southaven, MS
National Provider Identifier
1922287374
Registry record updated Jul 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
PA00215 Issued in MS
Practice address
7585 Clarington CV
Southaven, MS 38671-5656
Phone
(662) 349-0200
Fax
(662) 349-1666
NPI assigned
Nov 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Dermatology Physician 207N00000X PA00215 MS Primary

Addresses

Primary practice location

7585 Clarington CV
Southaven, MS 38671-5656

Mailing address

7585 Clarington CV
Southaven, MS 38671-5656
Phone (662) 349-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081215000154 AL Practitioner - Physician Assistant 8224190939 Reassigns benefits to 1 organization
I20141014001779 MS Practitioner - Physician Assistant 8224190939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Center of North Ms PAGroup PAC ID 7416006986, 7 clinicians

Practice addresses (Care Compare)

340 Court St
Tupelo, MS 38804-3910
Phone 66284462721005

Merit-based Incentive Payment System (MIPS)

Final score
98.5 of 100Reported as individual
Quality
100
Promoting interoperability
95
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00215MSMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cutaneous Oncology & Surgery Center, LLC Past Accepting new patients

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": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1922287374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7585 CLARINGTON CV",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715656",
            "telephone_number": "662-349-0200",
            "fax_number": "662-349-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7585 CLARINGTON CV",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715656",
            "telephone_number": "662-349-0200",
            "fax_number": "662-349-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONE",
        "first_name": "JENNIFER",
        "middle_name": "H",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MS",
            "license": "PA00215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.