Lasteffia J Todd, FNP
Individual provider Active NPI Nurse Practitioner · Choctaw, MS
NPI 1255414280 · NPPES record last updated Oct 17, 2007
Key facts
- NPI
- 1255414280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- R593656 (MS)
- Practice address
- 210 Hospital Cir
Choctaw, MS 39350-6781 - Phone
- (601) 656-2211
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100619000180 | TX | Practitioner - Nurse Practitioner | 4688704547 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mississippi Band of Choctaw Indians | Current |
Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current | Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current | Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current |
Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current | Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current | Accepting new patients |
Locations
1930 N Pearl St
Carthage, MS 39051
Phone (601) 287-6639
210 Hospital Cir
Choctaw, MS 39350
Phone (601) 389-4500
376 Campus Rd
Conehatta, MS 39057
Phone (601) 389-4500
124 Big Creek Cir
Philadelphia, MS 39350
Phone (601) 389-4500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R593656 | MS | Yes |
Addresses
Primary practice location
210 Hospital Cir
Choctaw, MS 39350-6781
Mailing address
210 Hospital Cir
Choctaw, MS 39350-6781
Phone (601) 656-2211
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04007266 | Medicaid | MS | |
| 00114872 | Medicaid | MS |
Other providers in Choctaw, MS
- Anna Singleton
- Patty Steve
- Rodney Steve
- Clarissa Stewart
- Diana Tangle
- Daniel Tubby
- Eugene Van Every
- Jennifer Michelle Waller-Smith
- Chester B Whittle
- Tiah Rae York
All providers in Choctaw, MS · Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.