Individual provider Active NPI

Aisha Renea Outlaw, FNP

  • Family Nurse Practitioner
  • Starkville, MS
National Provider Identifier
1174980478
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R866124 Issued in MS
Practice address
400 Hospital Rd
Starkville, MS 39759-2163
Phone
(662) 323-4320
NPI assigned
Jan 19, 2016
Last updated
Jan 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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 R866124 MS Primary

Addresses

Primary practice location

400 Hospital Rd
Starkville, MS 39759-2163

Mailing address

103 Eudora Welty Drive
J-02
Starkville, MS 39759-2163
Phone (662) 769-9781

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
I20160421001848 MS Practitioner - Nurse Practitioner 8729387915 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medplus Starkville LLCGroup PAC ID 8527474576, 3 clinicians

Practice addresses (Care Compare)

1207 Ms Hwy 182
Starkville, MS 39759-6388
Phone (662) 320-7800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R866124MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Triangle Urgent Care LLC Family CurrentSince Jun 1, 2024 Accepting new patients
Medplus New Albany LLC Family CurrentSince Jul 1, 2025 Accepting new patients
Medplus Fulton , LLC Current Accepting new patients
Medplus Starkville LLC Family CurrentSince Jul 1, 2025 Accepting new patients
Golden Triangle Urgent Care LLC Family CurrentSince Jun 1, 2024 Accepting new patients
Medplus Urgent Clinic LLC Family CurrentSince Jul 1, 2025 Accepting new patients

Locations

180 Park Plaza Dr
New Albany, MS 38652
Phone (662) 222-2273

1154 Cross Creek Dr
Saltillo, MS 38866
Phone (662) 840-8010

1207 Highway 182 W
Starkville, MS 39759
Phone (662) 320-7800

500 Russell St
Ste 3
Starkville, MS 39759
Phone (662) 324-2244

874 Barnes Crossing Rd
Tupelo, MS 38804
Phone (662) 841-0002

Interoperability endpoints

  • Direct secure messaging: aisha_outlaw_-_hospitalist_np@yourcarecommunity.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/BBJABD

Organizations & group practices 6

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": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1174980478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 EUDORA WELTY DRIVE",
            "address_2": "J-02",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397592163",
            "telephone_number": "662-769-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HOSPITAL RD",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397592163",
            "telephone_number": "662-323-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "AISHA",
        "middle_name": "RENEA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R866124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Starkville, MS

Sources for this page

Verify at the official NPI Registry.