Individual provider Active NPI

Lakendra NE'Shay Allen, FNP

  • Family Nurse Practitioner
  • Southaven, MS
National Provider Identifier
1346038205
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
907231 Issued in MS
Practice address
1161 Church Rd W
Southaven, MS 38671-7144
Phone
(662) 253-1067
NPI assigned
Apr 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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 907231 MS Primary

Addresses

Primary practice location

1161 Church Rd W
Southaven, MS 38671-7144

Mailing address

5410 Branchview Dr
Olive Branch, MS 38654-7487
Phone (601) 218-7572

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
I20250519002233 MS Practitioner - Nurse Practitioner 9032637541 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

6244 Hwy 305 N
Olive Branch, MS 38654
Phone (662) 782-5024

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Mississippi, PLLC Family CurrentSince May 1, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince May 1, 2025 Accepting new patients

Locations

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

1161 Church Rd W
Southaven, MS 38671
Phone (662) 253-1067

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.

NPI Registry JSON

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

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1346038205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 BRANCHVIEW DR",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547487",
            "telephone_number": "601-218-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 CHURCH RD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386717144",
            "telephone_number": "662-253-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "LAKENDRA",
        "middle_name": "NE'SHAY",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.