Individual provider Active NPI

Luezarah Robinson

  • Licensed Practical Nurse
  • Aberdeen, MS
National Provider Identifier
1104924646
Registry record updated Dec 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
P303655 Issued in MS
Practice address
133 E Commerce St
Aberdeen, MS 39730-2709
Phone
(662) 813-5151
Fax
(662) 813-5152
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X P303655 MS Primary

Addresses

Primary practice location

133 E Commerce St
Aberdeen, MS 39730-2709

Mailing address

188 Livingston Dr
Sturgis, MS 39769-4528
Phone (662) 617-3277

Other identifiers 2

IdentifierTypeStateIssuer
09328808MedicaidMS
08575397MedicaidMS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
P303655MSMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Luezarah Robinson Healthcare Services CurrentSince Dec 27, 2020 Accepting new patients
The We Care Committee Current Accepting new patients

Locations

133 E Commerce St
Aberdeen, MS 39730
Phone (662) 694-2604

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1104924646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 LIVINGSTON DR",
            "city": "STURGIS",
            "state": "MS",
            "postal_code": "397694528",
            "telephone_number": "662-617-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E COMMERCE ST",
            "city": "ABERDEEN",
            "state": "MS",
            "postal_code": "397302709",
            "telephone_number": "662-813-5151",
            "fax_number": "662-813-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "LUEZARAH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MS",
            "license": "P303655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09328808",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08575397",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; 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.