Mrs Jan Sullivan Randle, FNP - Medicare Nurse Practitioner in Louisville, MS

Mrs Jan Sullivan Randle, FNP is a medicare enrolled "Nurse Practitioner" in Louisville, Mississippi. She graduated from nursing school in 1997 and has 27 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Choctaw Regional Medical Center and her current practice location is 14724 Highway 15 N, Louisville, Mississippi. You can reach out to her office (for appointments etc.) via phone at (662) 773-7500.

Mrs Jan Sullivan Randle is licensed to practice in Mississippi (license number R652962) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1184675134.

Contact Information

Mrs Jan Sullivan Randle, FNP
14724 Highway 15 N,
Louisville, MS 39339-6318
(662) 773-7500
Not Available

Map and Direction




Provider's Profile

Full NameMrs Jan Sullivan Randle
GenderFemale
SpecialityNurse Practitioner
Experience27 Years
Location14724 Highway 15 N, Louisville, Mississippi
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mrs Jan Sullivan Randle graduated from nursing school in 1997
  NPI Data:
  • NPI Number: 1184675134
  • Provider Enumeration Date: 05/15/2006
  • Last Update Date: 03/10/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 8820045370
  • Enrollment ID: I20050406000664

Medical Identifiers

Medical identifiers for Mrs Jan Sullivan Randle such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1184675134NPI-NPPES
00118926MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner R652962 (Mississippi)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Sta Home Health And HospiceCarthage, MSHome health agency
Choctaw Regional Medical CenterAckerman, MSHospital
Winston Medical Center & SwingbedLouisville, MSHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Choctaw Regional Medical Center256768220636

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. Mrs Jan Sullivan Randle allows following entities to bill medicare on her behalf.
Entity NameChoctaw Regional Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235547878
PECOS PAC ID: 2567682206
Enrollment ID: O20141215002502

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. Mrs Jan Sullivan Randle 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 AddressPractice Location Address
Mrs Jan Sullivan Randle, FNP
8613 Ms Highway 12,
Ackerman, MS 39735-8917

Ph: (662) 285-9460
Mrs Jan Sullivan Randle, FNP
14724 Highway 15 N,
Louisville, MS 39339-6318

Ph: (662) 773-7500

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.