NPIMap

Individual provider Active NPI

Lisa H Hodge, CFNP

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1366774622
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R819978 Issued in MS
Practice address
4381 S Eason Blvd
Suite 201
Tupelo, MS 38801-6583
Phone
(662) 377-5005
Fax
(662) 377-5301
NPI assigned
Feb 10, 2010
Last updated
Mar 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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 R819978 MS Primary

Addresses

Primary practice location

4381 S Eason Blvd
Suite 201
Tupelo, MS 38801-6583

Mailing address

4381 S Eason Blvd
Suite 201
Tupelo, MS 38801-6583
Phone (662) 377-5005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100730000599 MS Practitioner - Nurse Practitioner 7113050931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3302 W Linden St
Suite a
Corinth, MS 38834-9119
Phone (662) 331-1956

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R819978MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center CurrentSince Jan 1, 2013 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Jan 1, 2013 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Medical Center, Inc. Past Accepting new patients
North Mississippi Medical Center, Inc Past Accepting new patients
Tupelo Anesthesia Group PA Past Accepting new patients
North Mississippi Medical Center Past Accepting new patients
North Mississippi Medical Center, Inc. Family Past Accepting new patients
North Mississippi Medical Center Past Accepting new patients

Locations

3302 W Linden St
#A
Corinth, MS 38834
Phone (662) 331-1956

4381 S Eason Blvd
Ste 101
Tupelo, MS 38801
Phone (662) 377-4054

4381 S Eason Blvd
Ste 201
Tupelo, MS 38801
Phone (662) 377-5005

806 Garfield St
Ste A
Tupelo, MS 38801

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

Interoperability endpoints

  • Direct secure messaging: lisahodge@nmhs.medalliesdirect.net

Organizations & group practices 10

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 5

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": "1265760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300665600000",
    "number": "1366774622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4381 S EASON BLVD",
            "address_2": "SUITE 201",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016583",
            "telephone_number": "662-377-5005",
            "fax_number": "662-377-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4381 S EASON BLVD",
            "address_2": "SUITE 201",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016583",
            "telephone_number": "662-377-5005",
            "fax_number": "662-377-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "LISA",
        "middle_name": "H",
        "credential": "CFNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-10",
        "last_updated": "2011-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R819978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.