Individual provider Active NPI

Robin Brinson, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1962905539
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
853129 Issued in MS
Practice address
3450 Highway 80 W
Jackson, MS 39209-7201
Phone
(601) 321-2400
Fax
(601) 985-5174
NPI assigned
Mar 9, 2018
Last updated
Mar 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 853129 MS Primary

Addresses

Primary practice location

3450 Highway 80 W
Jackson, MS 39209-7201

Mailing address

3450 Highway 80 W
Jackson, MS 39209-7201
Phone (601) 321-2400

Other identifiers 1

IdentifierTypeStateIssuer
00018209MedicaidMS

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
I20190603001037 MS Practitioner - Nurse Practitioner 5890028088 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
853129MSMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520553600000",
    "number": "1962905539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 HIGHWAY 80 W",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392097201",
            "telephone_number": "601-321-2400",
            "fax_number": "601-985-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 HIGHWAY 80 W",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392097201",
            "telephone_number": "601-321-2400",
            "fax_number": "601-985-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINSON",
        "first_name": "ROBIN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-09",
        "last_updated": "2018-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "853129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018209",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.