Individual provider Active NPI

Courtney Wages Tomlinson, CFNP

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1952568826
Registry record updated Nov 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R868601 Issued in MS
Practice address
350 W Woodrow Wilson Ave
Suite 1600
Jackson, MS 39213-7681
Phone
(601) 815-6869
NPI assigned
May 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2008

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 R868601 MS Primary

Addresses

Primary practice location

350 W Woodrow Wilson Ave
Suite 1600
Jackson, MS 39213-7681

Mailing address

350 W Woodrow Wilson Ave
Suite 1600
Jackson, MS 39213-7681
Phone (601) 815-6869

Other identifiers 1

IdentifierTypeStateIssuer
06879358MedicaidMS

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
I20081022000517 MS Practitioner - Nurse Practitioner 6901964741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R868601MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic PA CurrentSince Aug 17, 2023 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Aug 17, 2023 Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients

Locations

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

301 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-1700

Interoperability endpoints

  • Direct secure messaging: ctomlinson131724@directpatientrecord.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 and National Provider Directory roles.

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": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226880000000",
    "number": "1952568826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W WOODROW WILSON AVE",
            "address_2": "SUITE 1600",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137681",
            "telephone_number": "601-815-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W WOODROW WILSON AVE",
            "address_2": "SUITE 1600",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137681",
            "telephone_number": "601-815-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMLINSON",
        "first_name": "COURTNEY",
        "middle_name": "WAGES",
        "name_prefix": "Mrs.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R868601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06879358",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.