Jessica Carson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903286 Issued in MS

Practice address

1668 W Peace St
Canton, MS 39046-5332

Phone

(601) 859-5213

NPI assigned

Apr 23, 2019

Last updated

Apr 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Mallory Community HealthGroup PAC ID 9739074501, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessica.carson.1@19209.direct.athenahealth.com

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.

• Mallory Community Health

  dba Dr. Arenia C. Mallory Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lexington, MS
  • NPI 1740308873
  Medicare reassignment Care Compare group NPD
• Mallory Community Health

  • Federally Qualified Health Center (FQHC)
  • Lexington, MS
  • NPI 1508312992
  NPD

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1972167278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 E CENTER ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390463830",
            "telephone_number": "832-791-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1668 W PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390465332",
            "telephone_number": "601-859-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Canton Public School District
• Canton Vision Clinic, P.a.
• Cantons Physician Group
• Capital Emergency Physicians Madison PLLC
• Michael Caples, ED.S.,
• Catx, Inc
• Dewanna Chambliss
• Kajuandra Chandler-McDuffy, NP
• Angela L. Chandler, M.D.
• Takita Chaney

• Family Nurse Practitioner in Canton, MS
• Providers in Canton, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.