NPIMap

Individual provider Active NPI

Alchar G Jackson, CFNP

  • Nurse Practitioner
  • Biloxi, MS
National Provider Identifier
1932202876
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R873748 Issued in MS
Practice address
1046 Division St
Biloxi, MS 39530-2935
Phone
(228) 374-2494
Fax
(228) 374-0856
NPI assigned
Sep 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R873748 MS Primary

Addresses

Primary practice location

1046 Division St
Biloxi, MS 39530-2935

Mailing address

1046 Division St
Biloxi, MS 39530-2935
Phone (228) 374-2494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061211000317 MS Practitioner - Nurse Practitioner 4981603461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Gulfport, MS 39501-2460

1340 Broad Ave
Gulfport, MS 39501-2465

1756 Popps Ferry Rd
Biloxi, MS 39532-2118

3434 Bienville Blvd
Ocean Springs, MS 39564-5732
Phone (228) 875-1599

5120 Beatline Rd
Long Beach, MS 39560-3815

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R873748MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport Nurse Practitioner CurrentSince Apr 2, 2017 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Apr 2, 2017 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

Organizations & group practices 5

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.

Hospital & facility affiliations 64

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

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932202876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 DIVISION ST",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395302935",
            "telephone_number": "228-374-2494",
            "fax_number": "228-374-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 DIVISION ST",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395302935",
            "telephone_number": "228-374-2494",
            "fax_number": "228-374-0856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALCHAR",
        "middle_name": "G",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R873748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.