Individual provider Active NPI

Carli Crapps, NP

  • Family Health Clinical Nurse Specialist
  • Flowood, MS
National Provider Identifier
1134523111
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X
License
R885870 Issued in MS
Practice address
4436 Mangum Dr
Flowood, MS 39232-2113
Phone
(601) 586-7070
Fax
(601) 586-7071
NPI assigned
Oct 20, 2014
Last updated
Feb 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X R885870 MS Primary

Addresses

Primary practice location

4436 Mangum Dr
Flowood, MS 39232-2113

Mailing address

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5452

Other identifiers 1

IdentifierTypeStateIssuer
02879887MedicaidMS

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
I20141125000704 MS Practitioner - Nurse Practitioner 8527380732 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Vascular and Vein Associates LLCGroup PAC ID 2668863085, 4 clinicians

Practice addresses (Care Compare)

4436 Mangum Dr
Flowood, MS 39232-2113
Phone (601) 586-7070

Merit-based Incentive Payment System (MIPS)

Final score
97.34 of 100Reported as group
Quality
96.39
Improvement activities
40
Cost
69.99

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R885870MSMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Nov 10, 2014 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Nov 10, 2014 Accepting new patients
Advanced Vascular and Vein Associates, LLC CurrentSince Feb 1, 2022 Accepting new patients

Locations

4436 Mangum Dr
Flowood, MS 39232
Phone (601) 586-7070

778 Liberty Rd
Flowood, MS 39232
Phone (601) 914-9620

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

Interoperability endpoints

  • Direct secure messaging: carli.crapps.p1@direct.avva.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1134523111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5452",
            "fax_number": "601-815-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4436 MANGUM DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392322113",
            "telephone_number": "601-586-7070",
            "fax_number": "601-586-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAPPS",
        "first_name": "CARLI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-20",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "MS",
            "license": "R885870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02879887",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

Verify at the official NPI Registry.