PRIMARY AND BEHAVIORAL HEALTHCARE SERVICES, PA
NPI 1710545488
Nurse Practitioner - Psychiatric/Mental Health in Jackson, MS

Q: What is Primary And Behavioral Healthcare Services, PA's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since May 29, 2019

717 E. FORTIFICATION ST., JACKSON, MS 39202(769) 572-4009(769) 572-4021 Get Directions Write a Review

NPPES record last updated: October 4, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 4, 2024, Nov 10, 2021, Oct 14, 2019 and 1 more (4 updates tracked since 2019).

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About Primary And Behavioral Healthcare Services, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIMARY AND BEHAVIORAL HEALTHCARE SERVICES, PA (NPI 1710545488) is a healthcare organization registered as a psychiatric/mental health in Jackson, Mississippi and active in the NPI registry since May 2019. The organization maintains a secondary practice location in Monroe and lists Shameca L Hudson, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1710545488

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NamePRIMARY AND BEHAVIORAL HEALTHCARE SERVICES, PA

Location Address717 E. FORTIFICATION ST.Jackson, MS 39202-2402

Mailing Address717 E. Fortification St.Jackson, MS 39202-2402 · (769) 572-4009 · Fax (769) 572-4021

Phone(769) 572-4009

Fax(769) 572-4021

Organization SubpartNo

Authorized OfficialShameca L HudsonChief Executive Officer · (769) 572-4009

Enumeration DateMay 29, 2019

Last NPPES UpdateOctober 4, 20244 updates tracked since enumeration

NPPES CertifiedOctober 4, 2024

✔ NPI 1710545488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X

717 E. FORTIFICATION ST., Jackson, MS 39202

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Secondary Practice Location 1

Location 12252 Tower Dr Ste 108Monroe, LA 71201-5765 · Phone (769) 572-4009 · Fax (769) 572-4021

Other Identifiers 5

Medicaid005486078MS

Medicaid1679135982MS

Medicaid1710545488MS

Medicaid00000000MS

Medicaid858885MS

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Primary And Behavioral Healthcare Services, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Primary And Behavioral Healthcare Services, PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Shameca Hudson, DNP, FNP-BC,PMHNP-BC

Nurse Practitioner

NPI 1619362977

717 E FORTIFICATION ST
Jackson, MS 39202

(769) 572-4009

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Primary And Behavioral Healthcare Services, PA's NPI number?

The NPI number for Primary And Behavioral Healthcare Services, PA is 1710545488. It was assigned to this organization in the NPPES registry on May 29, 2019.

Where is Primary And Behavioral Healthcare Services, PA located?

Primary And Behavioral Healthcare Services, PA is located at 717 E. Fortification St., Jackson, MS 39202. The listed phone number is (769) 572-4009.

What is Primary And Behavioral Healthcare Services, PA's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Primary And Behavioral Healthcare Services, PA enrolled in Medicare?

Yes. Primary And Behavioral Healthcare Services, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Primary And Behavioral Healthcare Services, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Primary And Behavioral Healthcare Services, PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Primary And Behavioral Healthcare Services, PA was last updated on October 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.