Individual provider Active NPI

Charisma T. Cummings, PCNP

  • Gerontology Nurse Practitioner
  • Flowood, MS
National Provider Identifier
1992227177
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
876889 Issued in MS
Practice address
102 Riverview Drive
Suite a
Flowood, MS 39232
Phone
(601) 981-1610
Fax
(601) 366-2887
NPI assigned
Jul 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 876889 MS Primary

Addresses

Primary practice location

102 Riverview Drive
Suite a
Flowood, MS 39232

Mailing address

102 Riverview Drive
Suite a
Flowood, MS 39232
Phone (601) 981-1610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20220714004243 LA Practitioner - Nurse Practitioner 5698047645 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minor Med Care, LLCGroup PAC ID 7618866021, shared by 2 NPIs, 77 clinicians
MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

120 W Main St
Raymond, MS 39154-1223
Phone (601) 857-2341

1911 Mission
Vicksburg, MS 39180-3762
Phone (601) 456-2598

Merit-based Incentive Payment System (MIPS)

Final score
89.48 of 100Reported as group
Quality
73.04
Improvement activities
40
Cost
73.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
876889MSMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Care of St Gabriel LLC CurrentSince Oct 1, 2025 Accepting new patients
Heal All Wound Care LLC CurrentSince Sep 11, 2025 Accepting new patients

Locations

735 Highway 30
Bldg 1
Saint Gabriel, LA 70776
Phone (225) 314-9314

209 Front St
Vidalia, LA 71373
Phone (318) 336-6500

215 Katherine Dr
#A
Jackson, MS 39232

Interoperability endpoints

  • Direct secure messaging: charisma.cummings.1@8881.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992227177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 RIVERVIEW DRIVE",
            "address_2": "SUITE A",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "39232",
            "telephone_number": "601-981-1610",
            "fax_number": "601-366-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 RIVERVIEW DRIVE",
            "address_2": "SUITE A",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "39232",
            "telephone_number": "601-981-1610",
            "fax_number": "601-366-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMMINGS",
        "first_name": "CHARISMA",
        "middle_name": "T.",
        "credential": "PCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "876889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

Verify at the official NPI Registry.