Individual provider Active NPI

Raquel Janay Reed-Washington, FNP-C

  • Family Nurse Practitioner
  • Southaven, MS
National Provider Identifier
1336764778
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904716 Issued in MS
Practice address
3548 Herbert CV
Southaven, MS 38672-2003
Phone
(662) 910-9423
NPI assigned
Jun 11, 2020
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Mississippi Health Care Inc 8 clinicians

Practice addresses (Care Compare)

12 Brunswick St
Byhalia, MS 38611-7000
Phone (662) 838-2163

12 E Brunswick St
Byhalia, MS 38611-7000

PO Box
Suite 698
Byhalia, MS 38611

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
I20211115001276 MS Practitioner - Nurse Practitioner 7719376672 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
904716MSMDFamily Nurse Practitioner
27403TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Mississippi Health Care, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Northeast Mississippi Health Care, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Community Care Health Network LLC CurrentSince Mar 1, 2024 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

12 Brunswick St
Byhalia, MS 38611
Phone (601) 838-2163

232 Market St
Jackson, MS 39232
Phone (588) 498-6767

154 Mount Pleasant Rd
Mt Pleasant, MS 38635
Phone (662) 851-7939

Interoperability endpoints

  • Direct secure messaging: raquel.reedwashington@lcabe.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/HECABD

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 27403 TN
Family Nurse Practitioner 363LF0000X 904716 MS Primary

Addresses

NPPES NPI Registry

Primary practice location

3548 Herbert CV
Southaven, MS 38672-2003

Mailing address

PO Box 754
Coldwater, MS 38618-0754
Phone (662) 910-9423

Other practice location 1

12 Brunswick St
Byhalia, MS 38611-7000
Phone (662) 838-2163

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 8, 2021.

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1336764778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 754",
            "city": "COLDWATER",
            "state": "MS",
            "postal_code": "386180754",
            "telephone_number": "662-910-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3548 HERBERT CV",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386722003",
            "telephone_number": "662-910-9423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Brunswick St",
            "address_purpose": "LOCATION",
            "city": "Byhalia",
            "state": "MS",
            "postal_code": "386117000",
            "country_code": "US",
            "telephone_number": "662-838-2163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REED-WASHINGTON",
        "first_name": "RAQUEL",
        "middle_name": "JANAY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27403",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.