Individual provider Active NPI

Brandi Jo Lambert, FNP-C

  • Family Nurse Practitioner
  • Booneville, MS
National Provider Identifier
1043269236
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R873553 Issued in MS
Practice address
2209 N 2ND St
Booneville, MS 38829-7734
Phone
(662) 728-0162
NPI assigned
May 8, 2006
Last updated
Oct 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R873553 MS
Family Nurse Practitioner 363LF0000X R873553 MS Primary

Addresses

Primary practice location

2209 N 2ND St
Booneville, MS 38829-7734

Mailing address

408 Lois LN
Booneville, MS 38829-8231
Phone (662) 728-0162

Other identifiers 1

IdentifierTypeStateIssuer
08871366MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060720000417 MS Practitioner - Nurse Practitioner 5395758171 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Systems Management, LLCGroup PAC ID 5092964643, 49 clinicians

Practice addresses (Care Compare)

129 Ctr St
Suite B
Richland, MS 39218-4800
Phone (769) 233-7141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R873553MSMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Family Clinic of Booneville CurrentSince Feb 1, 2020 Accepting new patients
Medical Systems Management LLC CurrentSince Jun 1, 2023 Accepting new patients
Faith Family Clinic of Kossuth, LLC PastSince Aug 5, 2013 Accepting new patients
Kossuth Family Health Clinic Family Past Accepting new patients

Locations

2209 N 2nd St
Booneville, MS 38829
Phone (662) 728-0162

129 Center St
Ste B
Richland, MS 39218
Phone (769) 233-7141

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCCCBD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1043269236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 LOIS LN",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388298231",
            "telephone_number": "662-728-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 N 2ND ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388297734",
            "telephone_number": "662-728-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBERT",
        "first_name": "BRANDI",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "R873553",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R873553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08871366",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Booneville, MS

Sources for this page

Verify at the official NPI Registry.