Individual provider Active NPI

Laurie Selman Nimon, NP

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1265712145
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R878233 Issued in MS
Practice address
501 Marshall St
Suite 600
Jackson, MS 39202-1651
Phone
(601) 948-6540
Fax
(601) 326-1501
NPI assigned
Aug 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R878233 MS Primary

Addresses

Primary practice location

501 Marshall St
Suite 600
Jackson, MS 39202-1651

Mailing address

501 Marshall St
Suite 600
Jackson, MS 39202-1651
Phone (601) 948-6540

Other names 1

  • Laurie Selman Former name

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
I20120412000516 MS Practitioner - Nurse Practitioner 9830350198 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R878233MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revitalize Hydration Therapy, LLC CurrentSince Nov 16, 2020 Accepting new patients
North Sunflower Medical Center CurrentSince Aug 22, 2018 Accepting new patients
North Sunflower Medical Center CurrentSince Aug 22, 2018 Accepting new patients
Innovative Health LLC PastSince Jan 22, 2010 Accepting new patients
Bloom Health Services for Women Past Accepting new patients

Locations

885 Liberty Rd
Ste 300
Flowood, MS 39232
Phone (601) 213-0069

101 E Floyce St
Ruleville, MS 38771
Phone (662) 756-2100

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1265712145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST",
            "address_2": "SUITE 600",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021651",
            "telephone_number": "601-948-6540",
            "fax_number": "601-326-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST",
            "address_2": "SUITE 600",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021651",
            "telephone_number": "601-948-6540",
            "fax_number": "601-326-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMON",
        "first_name": "LAURIE",
        "middle_name": "SELMAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-23",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R878233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "SELMAN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.