Individual provider Active NPI

Terinei Lorel Andrews, REGISTERED NURSE

  • Addiction (Substance Use Disorder) Registered Nurse
  • Jackson, MS
National Provider Identifier
1053908780
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
904851 Issued in MS
Practice address
3450 Highway 80 W
Jackson, MS 39209-7201
Phone
(601) 321-2400
NPI assigned
Dec 29, 2020
Last updated
Dec 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 904851 MS Primary

Addresses

Primary practice location

3450 Highway 80 W
Jackson, MS 39209-7201

Mailing address

5155 Keele St Apt 9B
Jackson, MS 39206-4327
Phone (769) 230-6800

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Jackson Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
904851MSMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1053908780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 KEELE ST APT 9B",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064327",
            "telephone_number": "769-230-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 HIGHWAY 80 W",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392097201",
            "telephone_number": "601-321-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "TERINEI",
        "middle_name": "LOREL",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "MS",
            "license": "904851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Jackson",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3450 Highway 80 W",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392097201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.