Individual provider Active NPI

Denetta Ross, FNP-C

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1992149348
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R868748 Issued in MS
Practice address
5429 Robinson Road Ext
Jackson, MS 39204-4138
Phone
(601) 914-0163
NPI assigned
Apr 28, 2013
Last updated
Dec 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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 R868748 MS Primary

Addresses

Primary practice location

5429 Robinson Road Ext
Jackson, MS 39204-4138

Mailing address

5429 Robinson Road Ext
Jackson, MS 39204-4138

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
I20140320000973 MS Practitioner - Nurse Practitioner 6002047834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5429 Robinson Rd Ext
Jackson, MS 39204-4138
Phone (601) 914-0163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R868748MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Mississippi Health Services, Inc CurrentSince Nov 23, 2013 Accepting new patients
Central Mississippi Health Services, Inc Current Accepting new patients
Central Mississippi Health Services, Inc CurrentSince Nov 23, 2013 Accepting new patients

Locations

1134 Winter St
Jackson, MS 39204
Phone (601) 948-5572

5429 Robinson Road Ext
Jackson, MS 39204
Phone (601) 914-0163

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, 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": "1367107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1992149348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5429 ROBINSON ROAD EXT",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392044138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5429 ROBINSON ROAD EXT",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392044138",
            "telephone_number": "601-914-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "DENETTA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-28",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R868748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.