Individual provider Active NPI

Julie T Trice, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gautier, MS
National Provider Identifier
1184626905
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1-053065 Issued in AL
Practice address
3407 Shamrock CT
Gautier, MS 39553
Phone
(228) 497-0690
Fax
(228) 497-1363
NPI assigned
Aug 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 658766 MS
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1-053065 AL Primary

Addresses

Primary practice location

3407 Shamrock CT
Gautier, MS 39553

Mailing address

3929 Airport Blvd Ste 1-206
Mobile, AL 36609-2233
Phone (251) 721-9649

Other practice location 1

3407 Shamrock Ct
Gautier, MS 39553-5337
Phone (228) 497-0690

Other practice location 2

3407 Shamrock Ct
Gautier, MS 39553-5337
Phone (228) 497-0690

Other identifiers 1

IdentifierTypeStateIssuer
00018214MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050518000373 AL Practitioner - Nurse Practitioner 7113968397 Reassigns benefits to 1 organization
I20070927000274 MS Practitioner - Nurse Practitioner 7113968397 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-053065ALMDPsychiatric/Mental Health Nurse Practitioner
658766MSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Collective LLC CurrentSince Jan 5, 2026 Accepting new patients
Alabama Psychiatric Services PC Past Accepting new patients

Locations

3929 Airport Blvd
Ste 2-204
Mobile, AL 36609
Phone (251) 421-2812

960 Downtowner Blvd
Mobile, AL 36609
Phone (251) 480-0070

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1184626905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 AIRPORT BLVD STE 1-206",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366092233",
            "telephone_number": "251-721-9649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 SHAMROCK CT",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "39553",
            "telephone_number": "228-497-0690",
            "fax_number": "228-497-1363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3407 Shamrock Ct",
            "address_purpose": "LOCATION",
            "city": "Gautier",
            "state": "MS",
            "postal_code": "395535337",
            "country_code": "US",
            "telephone_number": "228-497-0690",
            "fax_number": "228-497-1363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3407 Shamrock Ct",
            "address_purpose": "LOCATION",
            "city": "Gautier",
            "state": "MS",
            "postal_code": "395535337",
            "country_code": "US",
            "telephone_number": "228-497-0690",
            "fax_number": "228-497-1363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRICE",
        "first_name": "JULIE",
        "middle_name": "T",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "658766",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-053065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018214",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gautier, MS

Sources for this page

Verify at the official NPI Registry.