Individual provider Active NPI

Lynn Carol Sharp, APRN

  • Critical Care Medicine Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1194397067
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
904654 Issued in MS
Practice address
1850 Chadwick Dr
Jackson, MS 39204-3404
Phone
(601) 376-1000
NPI assigned
Jul 12, 2021
Last updated
Jul 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 904654 MS Primary

Addresses

Primary practice location

1850 Chadwick Dr
Jackson, MS 39204-3404

Mailing address

130 Five Point LN # 0
Terry, MS 39170-9506
Phone (601) 672-5672

Other identifiers 2

IdentifierTypeStateIssuer
904654MedicaidMS
905654MedicaidMS

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Terry Direct
CONNECT URL Terry Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211209000261 MS Practitioner - Nurse Practitioner 1951791771 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Methodist Hospital & Rehabilitation Center, Inc. CurrentSince Nov 1, 2021 Accepting new patients
Mississippi Methodist Hospital & Rehabilitation Center, Inc. CurrentSince Nov 1, 2021 Accepting new patients
Ms Methodist Hospital & Rehabilitation Center Past Accepting new patients
Joyce D Wade Pulmonary & Sleep Specialist PastSince Dec 10, 2022 Accepting new patients

Locations

1350 E Woodrow Wilson Ave
Jackson, MS 39216
Phone (601) 364-5340

Organizations & group practices 5

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": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1194397067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 FIVE POINT LN # 0",
            "city": "TERRY",
            "state": "MS",
            "postal_code": "391709506",
            "telephone_number": "601-672-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 CHADWICK DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043404",
            "telephone_number": "601-376-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "LYNN",
        "middle_name": "CAROL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "MS",
            "license": "904654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "904654",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "905654",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Terry",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Terry",
            "address_1": "130 Five Point Ln # 0",
            "city": "Terry",
            "state": "MS",
            "country_code": "US",
            "postal_code": "391709506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Terry",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Terry",
            "address_1": "130 Five Point Ln # 0",
            "city": "Terry",
            "state": "MS",
            "country_code": "US",
            "postal_code": "391709506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.