Individual provider Active NPI

Yolanda Smith

  • Adult Health Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1043545874
Registry record updated Mar 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R881874 Issued in MS
Practice address
1040 River Oaks Dr
Suite 302
Jackson, MS 39232-9530
Phone
(601) 939-9923
NPI assigned
Oct 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R881874 MS Primary

Addresses

Primary practice location

1040 River Oaks Dr
Suite 302
Jackson, MS 39232-9530

Mailing address

3322 W End Ave
11TH Floor
Nashville, TN 37203-1031
Phone (615) 515-9880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20180904000502 SC Practitioner - Nurse Practitioner 1759414436 Practice locations: Chapin, SC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R881874MSMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mindcare Solutions PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19201/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394323200000",
    "number": "1043545874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3322 W END AVE",
            "address_2": "11TH FLOOR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031031",
            "telephone_number": "615-515-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR",
            "address_2": "SUITE 302",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392329530",
            "telephone_number": "601-939-9923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "YOLANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-13",
        "last_updated": "2014-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "R881874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.