North Laurel Family Medicine, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

NORTH LAUREL FAMILY MEDICINE, LLC

Practice address

3115 Audubon Dr
Laurel, MS 39440

Phone

(601) 531-2200

Fax

(601) 531-2220

NPI assigned

May 8, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Hope Jackson

Title

Billing/Credentialing

Phone

(601) 498-4673

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22845/brand/1/csg/1/fhir/r4

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Douglas Collins, NP

  • Nurse Practitioner
  • Sandersville, MS
  • NPI 1144532086
  Medicare reassignment Care Compare group NPD
• Anny S Evans, NP

  • Family Nurse Practitioner
  • Hattiesburg, MS
  • NPI 1346712791
  Medicare reassignment Care Compare group NPD
• Amanda Lucille Landrum-McCallum, C-FNP

  • Family Nurse Practitioner
  • Laurel, MS
  • NPI 1366943425
  Medicare reassignment Care Compare group NPD
• Jeffrey R. Moffett, FNP

  • Nurse Practitioner
  • Laurel, MS
  • NPI 1710135629
  Medicare reassignment Care Compare group NPD
• Brittany Lashea Reyes, FNP

  • Family Nurse Practitioner
  • Laurel, MS
  • NPI 1437938321
  Medicare reassignment Care Compare group NPD
• Charles Steven Wood Jr., NP-C

  • Family Nurse Practitioner
  • Laurel, MS
  • NPI 1356834766
  Medicare reassignment Care Compare group NPD
• Shannon Marie Wood, FNP-BC

  • Family Nurse Practitioner
  • Flowood, MS
  • NPI 1316517063
  Medicare reassignment Care Compare group NPD
• Sheila Diane Bradford, FNP

  • Family Nurse Practitioner
  • Laurel, MS
  • NPI 1700954765
  Medicare reassignment NPD
• Kayla Marie Cooley, FNP-C

  • Family Nurse Practitioner
  • Sandersville, MS
  • NPI 1003404732
  Medicare reassignment NPD
• Donna Lauren Johnson, FNP-C

  • Nurse Practitioner
  • Sandersville, MS
  • NPI 1255088167
  Medicare reassignment NPD
• Jennifer R Smith, FNP

  • Family Nurse Practitioner
  • Moselle, MS
  • NPI 1780354217
  NPD (past)

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1265921985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 AUDUBON DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401913",
            "telephone_number": "601-531-2200",
            "fax_number": "601-531-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 AUDUBON DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "39440",
            "telephone_number": "601-531-2200",
            "fax_number": "601-531-2220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 N Front Street",
            "address_purpose": "LOCATION",
            "city": "Sandersville",
            "state": "MS",
            "postal_code": "39477",
            "country_code": "US",
            "telephone_number": "601-490-7190",
            "fax_number": "601-490-7191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTH LAUREL FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-08",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "HOPE",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING",
        "authorized_official_telephone_number": "601-498-4673",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08886271",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Netherland Enterprises, Inc.
• Theresa Newbury, LPN
• Charlene Newell, CCSS
• Nicole Nielsen
• Britney Lanise Nobles, FNP
• Northlaurel Discount Drugs, Inc.
• Northlaurel Discount Drugs, Inc.
• Mark Norton, M.D.
• Sara A Norval, DPT
• Martha Nowell

• Nurse Practitioner in Laurel, MS
• Providers in Laurel, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.