Mr John Blake Endris, FNP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Jackson, Mississippi. He graduated from medical school in 2024 and has 1 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Southern Medical Consultants Llc and his current practice location is
2 Lenox Ct, Jackson, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(601) 421-3280.
Mr John Blake Endris is licensed to practice in Mississippi (license number 907149) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1780497503.
Physician's Profile
| Full Name | Mr John Blake Endris |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 1 Years |
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| Location | 2 Lenox Ct, Jackson, Mississippi |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr John Blake Endris graduated from medical school in 2024
NPI Data:
- NPI Number: 1780497503
- Provider Enumeration Date: 01/27/2025
- Last Update Date: 01/27/2025
Medicare PECOS Information:
- PECOS PAC ID: 8325564750
- Enrollment ID: I20250429002470
Medical Identifiers
Medical identifiers for Mr John Blake Endris such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780497503 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 907149 (Mississippi) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 907149 (Mississippi) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Southern Medical Consultants Llc | 9830496314 | 15 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr John Blake Endris allows following entities to bill medicare on his behalf.
| Entity Name | Southern Medical Consultants Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1215396577
PECOS PAC ID: 9830496314
Enrollment ID: O20160329000043 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr John Blake Endris is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mr John Blake Endris, FNP-C
383 Clarkdell Rd,
Canton, MS 39046-9465
Ph: () - | Mr John Blake Endris, FNP-C
2 Lenox Ct,
Jackson, MS 39211-4145
Ph: (601) 421-3280 |
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