Individual provider Active NPI

Janet D Pugh, APRN, BC

  • Family Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1114085776
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R661791 Issued in MS
Practice address
1451 N Lakeland Dr
Meridian, MS 39307-9020
Phone
(601) 581-8530
Fax
(601) 483-5543
NPI assigned
Dec 5, 2006
Last updated
Dec 12, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R661791 MS Primary

Addresses

Primary practice location

1451 N Lakeland Dr
Meridian, MS 39307-9020

Mailing address

PO Box 4128
Meridian, MS 39304-4128
Phone (601) 581-8530

Other identifiers 1

IdentifierTypeStateIssuer
04173532MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R661791MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Mississippi State Hospital CurrentSince Aug 2, 2020 Accepting new patients

Locations

1451 N Lakeland Dr
#P
Meridian, MS 39307
Phone (601) 581-7969

1455 N Lakeland Dr
#T
Meridian, MS 39307
Phone (601) 581-7969

Organizations & group practices 1

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1114085776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4128",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393044128",
            "telephone_number": "601-581-8530",
            "fax_number": "601-483-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 N LAKELAND DR",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393079020",
            "telephone_number": "601-581-8530",
            "fax_number": "601-483-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "JANET",
        "middle_name": "D",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R661791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04173532",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.