Individual provider Active NPI

Sarah Nicole Thames, FNP, MSN, RN

  • Family Nurse Practitioner
  • Laurel, MS
National Provider Identifier
1093373110
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903271 Issued in MS
Practice address
117 S 11TH Ave
Laurel, MS 39440-4312
Phone
(601) 425-3033
NPI assigned
Jun 4, 2019
Last updated
Jan 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Nurse Practitioner 363LC1500X 903271 MS
Family Nurse Practitioner 363LF0000X 903271 MS Primary

Addresses

Primary practice location

117 S 11TH Ave
Laurel, MS 39440-4312

Mailing address

PO Box 4361
Laurel, MS 39441-4361
Phone (601) 425-3033

Other identifiers 2

IdentifierTypeStateIssuer
NAMedicaidMS
NAOtherMSNA

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
I20191227001254 MS Practitioner - Nurse Practitioner 6204260268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Center, IncGroup PAC ID 9638163348, 8 clinicians

Practice addresses (Care Compare)

103 S 12TH Ave
Laurel, MS 39440-4322
Phone (601) 399-1948

117 S 11TH Ave
Laurel, MS 39440-4312
Phone 60142530331157

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
903271MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Homedica of Mississippi, LLC CurrentSince May 5, 2025 Accepting new patients
Family Health Center, Inc CurrentSince Sep 3, 2019 Accepting new patients
Family Health Center Inc CurrentSince Sep 3, 2019 Accepting new patients
Family Health Center, Inc Past Accepting new patients

Locations

1240 Broad Ave
Ste B
Gulfport, MS 39501
Phone (601) 456-5100

117 S 11th Ave
Laurel, MS 39440
Phone (601) 425-3033

Organizations & group practices 4

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": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1093373110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4361",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394414361",
            "telephone_number": "601-425-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S 11TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404312",
            "telephone_number": "601-425-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAMES",
        "first_name": "SARAH",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP, MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "MS",
            "license": "903271",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NA",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.