Paige Jackson
Individual provider Active NPI Nurse Practitioner · Meridian, MS
NPI 1972047264 · NPPES record last updated Dec 6, 2016
Key facts
- NPI
- 1972047264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 901728 (MS)
- Practice address
- 4715 24TH PL
Meridian, MS 39305-1686 - Phone
- (601) 696-6736
- NPI assigned
- Dec 6, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mississippi Band of Choctaw Indians
Practice addresses (Care Compare)
124 Big Creek Cir
Philadelphia, MS 39350-9004
Phone (601) 389-4500
210 Hospital Cir
Choctaw, MS 39350-6781
Phone (601) 389-4500
210 Hospital Circle
Choctaw, MS 39350-6781
Hospital & facility affiliations
- Choctaw Health Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230911000713 | TX | Practitioner - Nurse Practitioner | 5294003190 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mississippi Band of Choctaw Indians | Current | Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current |
Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current | Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current | Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current | Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current |
Accepting new patients |
Locations
1930 N Pearl St
Carthage, MS 39051
Phone (601) 287-6639
210 Hospital Cir
Choctaw, MS 39350
Phone (601) 389-4500
376 Campus Rd
Conehatta, MS 39057
Phone (601) 389-4500
124 Big Creek Cir
Philadelphia, MS 39350
Phone (601) 389-4500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 901728 | MS | Yes |
Addresses
Primary practice location
4715 24TH PL
Meridian, MS 39305-1686
Mailing address
11051 Road 779
Philadelphia, MS 39350-7437
Other providers in Meridian, MS
- J a Lauderdale III, DDS, PA
- J and J Inhome Care Agency
- J. Britt McCarty DMD PA
- Jackson Vamc
- Amanda Raye Jackson
- Quiyona Jackson
- Shannon Jackson
- Jacqueline L Pierre OD Faao LLC
- Mohamed Bockarie Jah
- James R. Watson, MD, Orthopedic & Sports Medicine, PLLC
All providers in Meridian, MS · Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.