Individual provider Active NPI

Lacee Nicole Lowder, MSN, APRN, FNP

  • Nurse Practitioner
  • Columbus, MS
National Provider Identifier
1043859697
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11190382 Issued in MS
Practice address
2520 5TH St N
Columbus, MS 39705-2008
Phone
(662) 244-1000
NPI assigned
Dec 30, 2019
Last updated
Dec 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11190382 MS Primary

Addresses

Primary practice location

2520 5TH St N
Columbus, MS 39705-2008

Mailing address

103 Ravenwood CV
Tupelo, MS 38804-7082
Phone (918) 214-5820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20210812000161 TN Practitioner - Nurse Practitioner 0244668507 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11190382MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Medical Group, PLLC CurrentSince Jan 1, 2022 Accepting new patients
Crossroads Urgent Care PLLC Nurse Practitioner CurrentSince Nov 2, 2021 Accepting new patients
Crossroads Urgent Care PLLC Nurse Practitioner CurrentSince Nov 2, 2021 Accepting new patients

Locations

1905 Gallatin Pike N
Madison, TN 37115
Phone (615) 338-7041

2445 Memorial Blvd
Ste C
Murfreesboro, TN 37129
Phone (615) 217-6900

3024 Gallatin Pike
Nashville, TN 37216
Phone (615) 665-4400

491 Sage Rd N
Ste 200
White House, TN 37188
Phone (615) 581-5925

Organizations & group practices 3

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": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1043859697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 RAVENWOOD CV",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388047082",
            "telephone_number": "918-214-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052008",
            "telephone_number": "662-244-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWDER",
        "first_name": "LACEE",
        "middle_name": "NICOLE",
        "credential": "MSN, APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-30",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "11190382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

Verify at the official NPI Registry.