Individual provider Active NPI

Harminder K Atwal, ACNP-BC

  • Acute Care Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1134427719
Registry record updated Mar 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R857613 Issued in MS
Practice address
1542 Medical Park Cir
Tupelo, MS 38801-6560
Phone
(662) 844-4711
Fax
(663) 844-9619
NPI assigned
Mar 7, 2011
Last updated
Mar 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R857613 MS Primary

Addresses

Primary practice location

1542 Medical Park Cir
Tupelo, MS 38801-6560

Mailing address

1542 Medical Park Cir
Tupelo, MS 38801-6560
Phone (662) 844-4711

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
I20110415000127 MS Practitioner - Nurse Practitioner 9537343579 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R857613MSMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Inc. CurrentSince Apr 1, 2016 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Apr 1, 2016 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Medical Center Inc Past Accepting new patients

Locations

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

830 S Gloster St
Ste B
Tupelo, MS 38801

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

961 S Gloster St
Ste A
Tupelo, MS 38801
Phone (662) 377-2964

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": "1299456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299456000000",
    "number": "1134427719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 MEDICAL PARK CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016560",
            "telephone_number": "662-844-4711",
            "fax_number": "663-844-9619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 MEDICAL PARK CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016560",
            "telephone_number": "662-844-4711",
            "fax_number": "663-844-9619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWAL",
        "first_name": "HARMINDER",
        "middle_name": "K",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-07",
        "last_updated": "2011-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "R857613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.