Individual provider Active NPI

Janice Outlaw, LPM

  • Licensed Practical Nurse
  • Greenwood, MS
National Provider Identifier
1205531324
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
220884 Issued in MS
Practice address
300 Star St
Greenwood, MS 38930-7528
Phone
(662) 392-4444
NPI assigned
Mar 31, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 220884 MS Primary

Addresses

Primary practice location

300 Star St
Greenwood, MS 38930-7528

Mailing address

300 Star St
Greenwood, MS 38930-7528
Phone (662) 392-4444

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

State licenses

LicenseStateTypeSpecialty
220884MSMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1205531324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 STAR ST",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389307528",
            "telephone_number": "662-392-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STAR ST",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389307528",
            "telephone_number": "662-392-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "JANICE",
        "credential": "LPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MS",
            "license": "220884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.