Individual provider Active NPI

Abigail Neary, FNP - C

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1952296618
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
907496 Issued in MS
Practice address
969 Lakeland Dr
Jackson, MS 39216-4606
Phone
(601) 200-2000
NPI assigned
Jun 11, 2025
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 907496 MS Primary

Addresses

Primary practice location

969 Lakeland Dr
Jackson, MS 39216-4606

Mailing address

122 Seville Way
Madison, MS 39110-8170
Phone (601) 209-7039

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
I20250722001827 MS Practitioner - Nurse Practitioner 0042726556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Dominic Jackson MemorialGroup PAC ID 4385531847, 56 clinicians

Practice addresses (Care Compare)

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 364-6175

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
907496MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Dominic Jackson Memorial CurrentSince Jun 12, 2025 Accepting new patients
St Dominic Hospital Crna's CurrentSince Jun 12, 2025 Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

Organizations & group practices 2

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": "1749600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1952296618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 SEVILLE WAY",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108170",
            "telephone_number": "601-209-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "601-200-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEARY",
        "first_name": "ABIGAIL",
        "credential": "FNP - C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.