Mr John Blake Endris, FNP-C is a
Nurse Practitioner - Family physician based in Jackson, Mississippi. Mr John Blake Endris is licensed to practice in Mississippi (license number 907149) and his current practice location is 2 Lenox Ct, Jackson, Mississippi. He can be reached at his office (for appointments etc.) via phone at
(601) 421-3280.
NPI number for Mr John Blake Endris is 1780497503 and his current mailing address is 383 Clarkdell Rd, Canton, Mississippi. He
does not participate in medicare program and thus does not accept medicare assignments. 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 - Family |
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| Location | 2 Lenox Ct, Jackson, Mississippi |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1780497503
- Provider Enumeration Date: 01/27/2025
- Last Update Date: 01/27/2025
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 |
|---|
| 207Q00000X | Family Medicine | 907149 (Mississippi) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 907149 (Mississippi) | Primary |
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
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
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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