Innovative Health LLC

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

Legal business name

INNOVATIVE HEALTH LLC

Practice address

501 Marshall St Ste 605
Jackson, MS 39202-1650

Phone

(601) 968-1690

Fax

(601) 968-1693

NPI assigned

Aug 20, 2009

Organization subpart

No

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

Authorized official

Name

Marie J Williams, NP

Title

Owner/Ceo

Phone

(601) 968-1690

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Laurie Selman Nimon, NP

  • Family Nurse Practitioner
  • Jackson, MS
  • NPI 1265712145
  NPD (past)

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1174755359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST STE 605",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021650",
            "telephone_number": "601-968-1690",
            "fax_number": "601-968-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST STE 605",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021650",
            "telephone_number": "601-968-1690",
            "fax_number": "601-968-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "601-968-1690",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06058256",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Obstetrics & Gynecology Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.