Individual provider Active NPI

Erin Mackenzie Cook, A-GNP-C

  • Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1932833639
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
905404 Issued in MS
Practice address
1410 E Woodrow Wilson Ave
Jackson, MS 39216-5114
Phone
(601) 984-5700
Fax
(601) 984-5733
NPI assigned
Jul 11, 2022
Last updated
Jul 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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 905404 MS Primary

Addresses

Primary practice location

1410 E Woodrow Wilson Ave
Jackson, MS 39216-5114

Mailing address

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5700

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
I20220929001339 MS Practitioner - Nurse Practitioner 6103202064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
905404MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 11, 2022 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 11, 2022 Accepting new patients
University Physicians, PLLC Past Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

1410 E Woodrow Wilson Ave
Jackson, MS 39216
Phone (601) 815-4775

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

Interoperability endpoints

  • Direct secure messaging: ecummins33281@ummc.direct-ci.com

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1932833639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5700",
            "fax_number": "601-984-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165114",
            "telephone_number": "601-984-5700",
            "fax_number": "601-984-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "ERIN",
        "middle_name": "MACKENZIE",
        "name_prefix": "Mrs.",
        "credential": "A-GNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "905404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.