Individual provider Active NPI

Lausha Marie White, REGISTER NURSE

  • Family Nurse Practitioner
  • Port Gibson, MS
National Provider Identifier
1114655883
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906396 Issued in MS
Practice address
88 Brady Ave
Port Gibson, MS 39150-2806
Phone
(601) 618-4115
NPI assigned
Aug 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 900891 MS
Family Nurse Practitioner 363LF0000X 906396 MS Primary

Addresses

Primary practice location

88 Brady Ave
Port Gibson, MS 39150-2806

Mailing address

88 Brady Ave
Port Gibson, MS 39150-2806
Phone (601) 618-4115

Other names 1

  • Lausha Marie Jefferson Former name

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
I20240731000041 MS Practitioner - Nurse Practitioner 4385181007 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Natchez After Hours Clinic, P.L.L.C.Group PAC ID 0648274555, 5 clinicians
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, shared by 4 NPIs, 192 clinicians

Practice addresses (Care Compare)

46 SGT Prentiss Dr
Suite 101
Natchez, MS 39120-4754
Phone (601) 442-1900

50 Veterans Memorial Dr
Kosciusko, MS 39090-3424
Phone (662) 307-2884

508 Hwy 61 N
Natchez, MS 39120-9049
Phone (601) 861-1631

517 City Ave S
Ripley, MS 38663-2517
Phone (662) 587-8206

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
900891MSMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 22, 2025 Accepting new patients
Fast Pace Mississippi, PLLC Single Specialty CurrentSince May 8, 2024 Accepting new patients
Upperline Healthcare, PC Single Specialty CurrentSince Sep 22, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince May 8, 2024 Accepting new patients

Locations

2798 Pass Rd
Biloxi, MS 39531
Phone (228) 200-0340

760 Brookway Blvd
Brookhaven, MS 39601
Phone (601) 748-7270

1050 Highway 98 Byp
Columbia, MS 39429
Phone (601) 522-2095

3265 Highway 90
Gautier, MS 39553
Phone (228) 366-9136

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

533 Lake St
Hazlehurst, MS 39083
Phone (601) 533-5253

1038 Northwest Ave
McComb, MS 39648
Phone (601) 730-7012

508 Highway 61 N
Natchez, MS 39120
Phone (601) 861-1631

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

2059 Highway 61 N
Vicksburg, MS 39183
Phone (601) 429-1144

451 Highway 90
Waveland, MS 39576
Phone (228) 400-0055

1130 Frontage Dr W
Wiggins, MS 39577
Phone (601) 716-8012

Organizations & group practices 5

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": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1114655883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 BRADY AVE",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502806",
            "telephone_number": "601-618-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 BRADY AVE",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502806",
            "telephone_number": "601-618-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "LAUSHA",
        "middle_name": "MARIE",
        "credential": "REGISTER NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "900891",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUSHA",
            "last_name": "JEFFERSON",
            "middle_name": "MARIE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Gibson, MS

Sources for this page

Verify at the official NPI Registry.