Jordan Larue Fulcher Jenkins, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903027 Issued in MS

Practice address

111 Kelly Blvd
Madison, MS 39110-1206

Phone

(601) 898-6080

NPI assigned

Nov 15, 2018

Last updated

Apr 29, 2024By the provider in NPPES

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

Other names 1

• Jordan Larue Fulcher Former name

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

Medserve, PAGroup PAC ID 8628253978, 7 clinicians

Medical Systems Management, LLCGroup PAC ID 5092964643, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Methodist Rehab Ctr Hospital, Jackson, MS, CCN 250152

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medserve, PA

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1871883223
  Medicare reassignment Care Compare group NPD
• Medical Systems Management LLC

  dba Rankin Rural Medical Clinic

  • Rural Health Clinic/Center
  • Richland, MS
  • NPI 1740555267
  Medicare reassignment Care Compare group

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

• Mississippi Methodist Hospital & Rehabilitation Center, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Tupelo, MS
  • NPI 1205604071

  Hospital

  Care Compare affiliation
• Mississippi Methodist Hospital & Rehabilitation Center, Inc.

  dba Methodist Rehab Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1841349792
  Care Compare affiliation

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1922577378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 FAWN CV",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390469417",
            "telephone_number": "601-919-5150",
            "fax_number": "888-240-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 KELLY BLVD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391101206",
            "telephone_number": "601-898-6080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3680 Lakeland Ln",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164707",
            "country_code": "US",
            "telephone_number": "601-982-5055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5420 US-80",
            "address_purpose": "LOCATION",
            "city": "Pearl",
            "state": "MS",
            "postal_code": "39208",
            "country_code": "US",
            "telephone_number": "601-988-6800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 River Oaks Dr",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MS",
            "postal_code": "390465351",
            "country_code": "US",
            "telephone_number": "601-607-9050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4540 Manhattan Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392066022",
            "country_code": "US",
            "telephone_number": "601-982-7421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "JORDAN",
        "middle_name": "LARUE FULCHER",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "FULCHER",
            "middle_name": "LARUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Madison, MS
• Providers in Madison, 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 Apr 29, 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.