Beverly L. Spicer, MSN, ACNP, CPNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

R869590 Issued in MS

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 815-1626

NPI assigned

Feb 27, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1053551283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5500",
            "fax_number": "601-984-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-815-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPICER",
        "first_name": "BEVERLY",
        "middle_name": "L.",
        "credential": "MSN, ACNP, CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-27",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "R869590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P01454865",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00380310",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denesha Spencer
• Jessie Moorefield Spencer, M.D.
• Latasha Spencer
• Lisa Spencer
• Teresa Spencer, CFNP
• Spine Medical Center of Jackson
• Brandi Spires
• Matthew Spitchley, MD
• Shanesse Spratt, MD
• Bailey Sprowles, FNP

• Acute Care Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Acute Care Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.