| Jason Michael Butler, NP | |
| 
					129 Center St Ste B, Richland, MS 39218-4800  | |
| (769) 233-7141 | |
| Not Available | 
| Full Name | Jason Michael Butler | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Practitioner - Adult Health | 
| Location | 129 Center St Ste B, Richland, Mississippi | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1417467168 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LA2200X | Nurse Practitioner - Adult Health | 902078 (Mississippi) | Primary | 
| 363LG0600X | Nurse Practitioner - Gerontology | 902078 (Mississippi) | Secondary | 
| Entity Name | Southern Medical Consultants Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1215396577 PECOS PAC ID: 9830496314 Enrollment ID: O20160329000043  | 
| Entity Name | Community Care Health Network Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1619368842 PECOS PAC ID: 8527324151 Enrollment ID: O20210520000556  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Jason Michael Butler, NP 314 Cypress Creek Rd, Brandon, MS 39047-7989 Ph: (601) 421-1128  | Jason Michael Butler, NP 129 Center St Ste B, Richland, MS 39218-4800 Ph: (769) 233-7141  | 
Laquana Daniels,  Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 119 Rhemann Blvd, Richland, MS 39218 Phone: 601-248-5198  | |
Denisa Broome Wilson, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 907 Us 49, Richland, MS 39218 Phone: 601-374-5263  | |
Mr. James A Marx, C.F.N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1201 Highway 49 S, Suite 4, Richland, MS 39218 Phone: 601-932-6400 Fax: 601-932-6437  | |
Ashley Smith Allen, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Rankin Rural Medical Center, 129 Center Street Suite B, Richland, MS 39218 Phone: 769-233-7141  | |
Darby Raybourn Wade, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 128 Riverview Dr, Richland, MS 39218 Phone: 601-326-1960 Fax: 601-326-1706  | |
Carrington Albernise Sallie, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 907 Highway 49 S, Richland, MS 39218 Phone: 601-374-5263  | |
Linda Nell Hunter, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1201 Highway 49 S Ste 4, Richland, MS 39218 Phone: 601-932-6400 Fax: 601-664-0006  |