JAMIE VICE FORTNER (NPI# 1992139976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992139976 |
| Entity Type | Individual |
| Full Name | JAMIE VICE FORTNER |
| Credential | FNP |
| Practice Address |
1203 Medical Park Dr Oxford MS 38655-5327 |
| Practice Telephone | 6625134399 |
| Practice Fax Number | 6625134330 |
| Mailing Telephone | 6625134399 |
| Mailing Fax Number | 6625134330 |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2014-08-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | F0613716 | MS | Allopathic & Osteopathic Physicians |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R878817 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1203 MEDICAL PARK DR |
| City | OXFORD |
| State | MS |
| Zip Code | 38655-5327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538131594 | Jonathan S. C. Caudill | Pediatrics | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2006-02-03 |
| 1255988580 | Adriana Lyn Jenkins | Nurse Practitioner | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2019-08-21 |
| 1407328412 | Leslie Bensieck | Social Worker | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2019-01-02 |
| 1972080257 | Right Track Medical Group, Inc | Psychiatry & Neurology | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2018-07-19 |
| 1932590452 | Mallory Mckenzie Warrington Wills | Nurse Practitioner | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2015-02-06 |
| 1568757201 | James Edward Warrington IIi | Student in an Organized Health Care Education/Training Program | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2011-06-10 |
| 1215245931 | Meggan Hanson Blaylock | Counselor | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2010-09-15 |
| 1992035000 | Kathryn K Wiygul | Nurse Practitioner | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2010-01-12 |
| 1407917453 | Molly Simpson Singletary | Pediatrics | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2006-12-13 |
| 1639230675 | William Douglas Sanford Jr. | Pediatrics | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2006-12-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619585809 | Oxford Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 616 Commerce Parkway, Oxford, MS 38655 | 2020-07-14 |
| 1760044465 | Lindsay Low Beauchamp | Speech-Language Pathologist | 169 Ms-6 #102, Oxford, MS 38655 | 2019-07-02 |
| 1861058075 | Tomiko D Mackey | Social Worker | 100 Carriage Cove, Oxford, MS 38655 | 2019-05-13 |
| 1174090039 | Derionne Brooks | Specialist/Technologist | 972 Hathorn Road, University, MS 38655 | 2018-10-30 |
| 1497236327 | Providence Companion Care | Nurse's Aide | 317 Heritage Dr Ste 3b, Oxford, MS 38655 | 2018-08-28 |
| 1255817292 | Marcela Caroline Weber | Counselor | 152 Mississippi 7 South, Oxford, MS 38655 | 2018-07-12 |
| 1649775123 | Oxford Outpatient Center, LLC | Clinic/Center | 611 Commerce Pkwy, Oxford, MS 38655 | 2018-03-27 |
| 1073039962 | Sharon Yvette Holloway | Social Worker | 152 Hwy and South, Oxford, Ms 38655, Oxford, MS 38655 | 2017-08-22 |
| 1447774682 | Courtney M Purvis | Physical Therapist | 300 Enterprise Dr Ste B, Oxford, MS 38655 | 2017-07-31 |
| 1649716580 | Taylor Lynn Smith | Counselor | 152 Ms-7, Oxford, MS 38655 | 2017-01-17 |
| Find all providers in zip 38655 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124632716 | Oxford Specialty Clinic | Nurse Practitioner | 1205 Office Park Dr, Oxford, MS 38655-3545 | 2020-09-01 |
| 1659994044 | Christopher Killis Scruggs | Nurse Practitioner | 132 Yocona Ridge Rd, Oxford, MS 38655-6904 | 2020-05-20 |
| 1164062105 | Sarah Marie Fitzpatrick | Nurse Practitioner | 1070 Brookside Ct, Oxford, MI 48371-6055 | 2020-01-07 |
| 1710522198 | Laura Nicole Kelleway | Nurse Practitioner | 23 County Road 205, Oxford, MS 38655-9794 | 2019-11-09 |
| 1780225441 | Lija Turaida Moncrieff-austin | Nurse Practitioner | 500 E Peninsula Ct, Oxford, MI 48371-3669 | 2019-10-03 |
| 1861044026 | Mirian Thiruchendru | Nurse Practitioner | 72 S Washington St Ste 102, Oxford, MI 48371-6421 | 2019-07-09 |
| 1649752312 | Aubrey Michelle Mcintosh | Nurse Practitioner | 904 Crestmoor Dr, Oxford, MI 48371-4870 | 2018-08-30 |
| 1760969208 | Tina Gail Bryan | Nurse Practitioner | 7 County Road 469, Oxford, MS 38655-8279 | 2018-07-27 |
| 1699277509 | Lindsey Wall Hemphill | Nurse Practitioner | 45 County Road 277, Oxford, MS 38655-8739 | 2018-03-06 |
| 1023527017 | Katherine Waters | Nurse Practitioner | 2301 S Lamar Blvd # 140, Oxford, MS 38655-5373 | 2017-09-22 |
| Find all providers in OXFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.