Individual provider Active NPI

Lorraine Gaddis, CFNP

  • Nurse Practitioner
  • Madison, MS
National Provider Identifier
1205896842
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R741224 Issued in AL
Practice address
127 Grandview Dr
Madison, MS 39110-7595
Phone
(601) 853-0203
NPI assigned
Mar 27, 2006
Last updated
Jun 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R741224 AL Primary

Addresses

Primary practice location

127 Grandview Dr
Madison, MS 39110-7595

Mailing address

PO Box 23666
Jackson, MS 39225-3666
Phone (601) 200-4749

Other identifiers 1

IdentifierTypeStateIssuer
03282005MedicaidMS

Other names 1

  • Mrs. Lorraine Hamm Former name

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R741224ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Nursing Associates PLLC Past Accepting new patients

Organizations & group practices 1

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1205896842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23666",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253666",
            "telephone_number": "601-200-4749",
            "fax_number": "601-200-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 GRANDVIEW DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107595",
            "telephone_number": "601-853-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDIS",
        "first_name": "LORRAINE",
        "name_prefix": "Ms.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "R741224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03282005",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORRAINE",
            "last_name": "HAMM",
            "prefix": "MRS.",
            "credential": "CFNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.