Individual provider Active NPI

Rachel Temple

  • Family Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1285171074
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
901951 Issued in MS
Practice address
1102 Constitution Ave
Meridian, MS 39301-4001
Phone
(601) 282-8980
Fax
(601) 693-6561
NPI assigned
Jan 31, 2017
Last updated
Apr 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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 901951 MS Primary

Addresses

Primary practice location

1102 Constitution Ave
Meridian, MS 39301-4001

Mailing address

PO Box 4176
Houma, LA 70361-4176
Phone (985) 872-5864

Other identifiers 1

IdentifierTypeStateIssuer
APPLIEDMedicaidMS

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
I20170324001745 MS Practitioner - Nurse Practitioner 7618252131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Institute of the South, LLCGroup PAC ID 3779497441, 145 clinicians

Practice addresses (Care Compare)

4909 Great River Dr
Meridian, MS 39305-2664
Phone (601) 282-8980

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1285171074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4176",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703614176",
            "telephone_number": "985-872-5864",
            "fax_number": "985-872-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 CONSTITUTION AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014001",
            "telephone_number": "601-282-8980",
            "fax_number": "601-693-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPLE",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-31",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPLIED",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.