Active NPI
Audrey L Krasin, MD
- Pediatrics Physician
- Southaven, MS
National Provider Identifier
1144337155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 18650
- Practice address
- 7276 Southcrest Pkwy
Southaven, MS 38671 - Phone
- (662) 349-6577
- Fax
- (662) 349-6562
- NPI assigned
- Aug 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 18650 | MS | Primary |
Addresses
Primary practice location
7276 Southcrest Pkwy
Southaven, MS 38671
Mailing address
104 Court Street
Senatobia, MS 38668
Phone (662) 562-4418
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00123983 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18650 | MS | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Memorial Hospital-Desoto, Inc, | Past | Accepting new patients | |
| Sidhu Pediatrics, LLC | Pediatrics | Past | Accepting new patients |
| Methodist Healthcare - Olive Branch Hospital | Past | Accepting new patients | |
| Sidhu Pediatrics, LLC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- akrasin22429@mlh.direct-ci.com
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Southaven, MS
- NPI 1194789818
-
- General Acute Care Hospital
- Olive Branch, MS
- NPI 1912341439
-
- Pediatrics Physician
- Southaven, MS
- NPI 1326261843
-
- Pediatrics Physician
- Senatobia, MS
- NPI 1336369156
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144337155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 COURT STREET",
"city": "SENATOBIA",
"state": "MS",
"postal_code": "38668",
"telephone_number": "662-562-4418",
"fax_number": "662-562-9024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7276 SOUTHCREST PKWY",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "38671",
"telephone_number": "662-349-6577",
"fax_number": "662-349-6562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRASIN",
"first_name": "AUDREY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MS",
"license": "18650",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00123983",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.