Blaise Fondren, in Oxford, MS - Medicare Nurse Practitioner

Blaise Fondren, is a medicare enrolled "Nurse Practitioner - Family" in Oxford, Mississippi. Her current practice location is 2222 Jackson Ave W, Oxford, Mississippi. You can reach out to her office (for appointments etc.) via phone at (662) 380-5560.

Blaise Fondren is licensed to practice in Mississippi (license number 906484) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1679341630.

Contact Information

	Blaise Fondren,
	2222 Jackson Ave W, Oxford, MS 38655-5409
	(662) 380-5560
	Not Available

Map and Direction

Provider's Profile

Full Name	Blaise Fondren
Gender	Female
Speciality	Nurse Practitioner - Family
Location	2222 Jackson Ave W, Oxford, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1679341630
Provider Enumeration Date: 12/19/2023
Last Update Date: 07/28/2025

Medicare PECOS Information:

PECOS PAC ID: 2062851264
Enrollment ID: I20240422000485

Medical Identifiers

Medical identifiers for Blaise Fondren such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1679341630	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	899036 (Mississippi)	Secondary
363LF0000X	Nurse Practitioner - Family	36596 (Tennessee)	Secondary
363LF0000X	Nurse Practitioner - Family	906484 (Mississippi)	Primary

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. Blaise Fondren allows following entities to bill medicare on her behalf.

Entity Name	Yalobusha General Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740380914 PECOS PAC ID: 4486601648 Enrollment ID: O20050331000530

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. Blaise Fondren 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
Blaise Fondren, 420 Live Oak Dr, Oxford, MS 38655-2962 Ph: (901) 337-5548	Blaise Fondren, 2222 Jackson Ave W, Oxford, MS 38655-5409 Ph: (662) 380-5560

Reviews and Comments

Nurse Practitioner Nurses in Oxford, MS

Mrs. Rachel Jamison Sledge, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1487 Belk Blvd, Oxford, MS 38655 Phone: 662-234-1090 Fax: 662-234-0432
Shavonne Bridgette Doyle, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2908 S Lamar Blvd Ste 100, Oxford, MS 38655 Phone: 662-281-0112
Kathryn B Elliott, WHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 551 Azalea Dr, Oxford, MS 38655 Phone: 662-234-0332 Fax: 662-234-2891
Katherine Waters Shields, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 Baptist Memorial Cir Ste 120, Oxford, MS 38655 Phone: 662-244-2288 Fax: 662-636-2285
Casey Tramel, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2706 W Oxford Loop Ste 105, Oxford, MS 38655 Phone: 662-550-4250
Kimberly Anne Schweigart, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 705 Sisk Ave, Oxford, MS 38655 Phone: 662-638-1002
Olivia Babb Cooper, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2706 W Oxford Loop Ste 105, Oxford, MS 38655 Phone: 662-550-4250 Fax: 662-550-4612

Blaise Fondren, - Medicare Nurse Practitioner in Oxford, MS