Individual provider Active NPI

Stephanie Creshell Ruffin, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1124791512
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
904782 Issued in MS
Practice address
2401 State Blvd
Meridian, MS 39307-5033
Phone
(601) 282-8226
Fax
(601) 512-0443
NPI assigned
Jul 30, 2021
Last updated
Nov 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 235559 LA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 904782 MS Primary

Addresses

Primary practice location

2401 State Blvd
Meridian, MS 39307-5033

Mailing address

2399 Long Creek Rd
Meridian, MS 39301-9342
Phone (601) 701-5609

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address hcotg2020@outlook.com Direct
Direct Messaging Address hcotg@outlook.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210907000078 MS Practitioner - Nurse Practitioner 2163828898 Reassigns benefits to 5 organizations
I20240808001223 LA Practitioner - Nurse Practitioner 2163828898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Forefront Telecare IncGroup PAC ID 9638319114, 29 clinicians
Healthcareonthego, LLCGroup PAC ID 0042563231, 4 clinicians

Practice addresses (Care Compare)

125 Turner St Unit
14 Mary Anna Nursing Home
Wisner, LA 71378
Phone (972) 449-0540

2399 Long Creek Rd
Meridian, MS 39301-9342
Phone (601) 701-5609

2401 State Blvd
Meridian, MS 39307-5033
Phone (601) 282-2886

248 E Capitol St
Suite 840
Jackson, MS 39201-2505
Phone (972) 449-0540

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access Telecare, PLLC CurrentSince Jan 27, 2025 Accepting new patients
Peaceful Mind Psychiatry Psychiatric/Mental Health CurrentSince Dec 20, 2023 Accepting new patients
Forefront Telecare Inc CurrentSince May 17, 2023 Accepting new patients
Alliance Health Center Inc. Psychiatric/Mental Health CurrentSince Mar 4, 2024 Accepting new patients
Healthcareonthego, LLC Psychiatric/Mental Health CurrentSince Aug 15, 2021 Accepting new patients

Locations

600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100

187 Ninth St
Jena, LA 71342
Phone (318) 992-9200

103 Millcreek Cors
Brandon, MS 39047
Phone (601) 207-2017

248 E Capitol St
Ste 840
Jackson, MS 39201

2401 State Blvd
Meridian, MS 39307
Phone (601) 282-2886

5000 Highway 39 N
Meridian, MS 39301
Phone (601) 483-6211

Interoperability endpoints

  • Direct secure messaging: stephanie.ruffin.1@24287.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1124791512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2399 LONG CREEK RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393019342",
            "telephone_number": "601-701-5609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 STATE BLVD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393075033",
            "telephone_number": "601-282-8226",
            "fax_number": "601-512-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFIN",
        "first_name": "STEPHANIE",
        "middle_name": "CRESHELL",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-30",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "235559",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "904782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hcotg2020@outlook.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2401 State Blvd",
            "city": "Meridian",
            "state": "MS",
            "country_code": "US",
            "postal_code": "393075033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hcotg@outlook.com",
            "affiliation": "N",
            "address_1": "2401 State Blvd",
            "city": "Meridian",
            "state": "MS",
            "country_code": "US",
            "postal_code": "393075033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.