Arise Hernando, LLC
Organization Active NPI Psychiatry Physician · Hernando, MS
NPI 1124709993 · NPPES record last updated Jul 26, 2023
Key facts
- NPI
- 1124709993
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- ARISE HERNANDO, LLC
- Practice address
- 1288 Byhalia Rd Ste 4
Hernando, MS 38632-6032 - Phone
- (662) 432-4106
- NPI assigned
- Jul 26, 2023
- Organization subpart
- No
Authorized official
- Name
- Jay Howell
- Title
- Chief Revenue Officer
- Phone
- (662) 205-5999
Practitioners 7
-
Davis Abraham, LPC
-
Lara J Hayes, M.ED., LPC
-
Ginnifer Poole Hutcheson, DNP, PMHNP-BC
-
Melissa Renee Smith, APRN
-
Aracelis Johanna Lu Brea, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240103003690 | MS | Part B Supplier - Clinic/Group Practice | 5799136792 |
Receives reassigned benefits from 6 practitioners Practice locations: Hernando, MS |
National Provider Directory
Locations
1288 Byhalia Rd
Ste 4
Hernando, MS 38632
Phone (662) 912-9218
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | Yes |
Addresses
Primary practice location
1288 Byhalia Rd Ste 4
Hernando, MS 38632-6032
Mailing address
PO Box 7058
Tupelo, MS 38802-7058
Other providers in Hernando, MS
- Agilitas USA, Inc
- Kathryn Alred
- Craig Stephen Andreas Jr.
- Apelah
- Archipoimen PLLC
- Atlantic Diagnostic Services, LLC
- Atlantic Medical, LLC
- Christa Leigh Aven
- Awakening Wellness Clinic LLP
- Donna Renee Aycock
All providers in Hernando, MS · Psychiatry Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.