Individual provider Active NPI

Cynthia D Rouse, CFNP

  • Specialist
  • Hattiesburg, MS
National Provider Identifier
1245331859
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
R614505 Issued in MS
Practice address
1 Lincoln Pkwy
Ste 300
Hattiesburg, MS 39402-3262
Phone
(601) 579-4440
Fax
(601) 579-4460
NPI assigned
Sep 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X R614505 MS Primary

Addresses

Primary practice location

1 Lincoln Pkwy
Ste 300
Hattiesburg, MS 39402-3262

Mailing address

1 Lincoln Pkwy
Ste 300
Hattiesburg, MS 39402-3262
Phone (601) 579-4440

Other identifiers 1

IdentifierTypeStateIssuer
00125874MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040316000903 MS Practitioner - Nurse Practitioner 3577453406 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Jan 1, 2008 Accepting new patients
Forrest County General Hospital CurrentSince Jan 1, 2008 Accepting new patients
Forrest County General Hospital Current Accepting new patients
Southern Medical Imaging Past Accepting new patients

Locations

1 Lincoln Pkwy
Ste 202
Hattiesburg, MS 39402
Phone (601) 288-8050

2117 Broadway Dr
Hattiesburg, MS 39402
Phone (601) 288-8050

Organizations & group practices 4

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245331859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LINCOLN PKWY",
            "address_2": "STE 300",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023262",
            "telephone_number": "601-579-4440",
            "fax_number": "601-579-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LINCOLN PKWY",
            "address_2": "STE 300",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023262",
            "telephone_number": "601-579-4440",
            "fax_number": "601-579-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSE",
        "first_name": "CYNTHIA",
        "middle_name": "D",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "R614505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125874",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.