Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Cantrell Ollie Anderson

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1780356212

Cantrell Ollie Anderson is a Nurse Practitioner in Jackson, Mississippi. Qualified in 2021, 5 years ago. Practices with Medical Foundation of Central Mississippi Inc, a 273-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
5
Licensed in
MS
In the registry since
2021
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Practice location Address checks out

1225 N State St
Jackson, MS 39202-2064
Phone: (601) 968-1031
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 969 Lakeland Drive, Jackson, MS 39216 — (662) 590-3658

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 906306 (MS)

Record details

NPI number1780356212
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 3, 2021
Last updated in NPPESSeptember 13, 2024
Certification dateSeptember 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Medical Foundation Of Central Mississippi Inc — 273 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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