Individual provider Active NPI

Yalayna Green

  • Family Nurse Practitioner
  • Long Beach, MS
National Provider Identifier
1124812789
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906929 Issued in MS
Practice address
110 E Railroad St
Long Beach, MS 39560-4625
Phone
(228) 678-7036
NPI assigned
Apr 8, 2025
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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 906929 MS Primary

Addresses

Primary practice location

110 E Railroad St
Long Beach, MS 39560-4625

Mailing address

PO Box 306415
Nashville, TN 37230-6415

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
I20250508001241 MS Practitioner - Nurse Practitioner 3577080001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

110 E Railroad St
Long Beach, MS 39560-4625
Phone (228) 678-7036

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Mississippi, PLLC Family CurrentSince Mar 6, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Mar 6, 2025 Accepting new patients

Locations

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

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

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

Organizations & group practices 4

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": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1124812789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306415",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E RAILROAD ST",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395604625",
            "telephone_number": "228-678-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "YALAYNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, MS

Sources for this page

Verify at the official NPI Registry.