Individual provider Active NPI

Sandreal A Pounds, LPN

  • Licensed Practical Nurse
  • Hattiesburg, MS
National Provider Identifier
1215539689
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2-073401 Issued in AL
Practice address
115 Thornhill Dr Ste a
Hattiesburg, MS 39402-1559
Phone
(601) 653-7536
Fax
(769) 500-1661
NPI assigned
Nov 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 337543 MS
Licensed Practical Nurse 164W00000X 2-073401 AL Primary

Addresses

Primary practice location

115 Thornhill Dr Ste a
Hattiesburg, MS 39402-1559

Mailing address

PO Box 763
Hattiesburg, MS 39403-0763
Phone (601) 653-7536

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
2-073401ALMDLicensed Practical Nurse
337543MSMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1215539689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 763",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394030763",
            "telephone_number": "601-653-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 THORNHILL DR STE A",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021559",
            "telephone_number": "601-653-7536",
            "fax_number": "769-500-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POUNDS",
        "first_name": "SANDREAL",
        "middle_name": "A",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MS",
            "license": "337543",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AL",
            "license": "2-073401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.