Active NPI
Debra Fahey, FNP
- Nurse Practitioner
- Ocean Springs, MS
National Provider Identifier
1245320456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R874987
- Practice address
- 1514 Bienville Blvd
Ocean Springs, MS 39564-3006 - Phone
- (228) 382-9222
- Fax
- (228) 382-9224
- NPI assigned
- Oct 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R874987 | MS | Primary |
Addresses
Primary practice location
1514 Bienville Blvd
Ocean Springs, MS 39564-3006
Mailing address
PO Box 1248
Ocean Springs, MS 39566-1248
Phone (228) 382-9222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03334708 | Medicaid | MS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R874987 | MS | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373932800000",
"number": "1245320456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1248",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395661248",
"telephone_number": "228-382-9222",
"fax_number": "228-382-9224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1514 BIENVILLE BLVD",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395643006",
"telephone_number": "228-382-9222",
"fax_number": "228-382-9224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAHEY",
"first_name": "DEBRA",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2013-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "R874987",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03334708",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ocean Springs, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.