Individual provider Active NPI

Cindy R. Patrick, FNP-C

  • Family Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1366877268
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
850743 Issued in MS
Practice address
2124 14TH St
Meridian, MS 39301-4040
Phone
(601) 553-6466
Fax
(601) 553-6072
NPI assigned
Sep 10, 2013
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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 850743 MS Primary

Addresses

Primary practice location

2124 14TH St
Meridian, MS 39301-4040

Mailing address

PO Box 749215
Atlanta, GA 30374-9215
Phone (901) 226-3186

Other practice location 1

1100 17th Ave
Meridian, MS 39301-4219
Phone (601) 703-1465

Other practice location 2

2024 15th St Fl 2
Meridian, MS 39301-4130
Phone (601) 553-2000

Other identifiers 1

IdentifierTypeStateIssuer
02850756MedicaidMS

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
I20131107000678 MS Practitioner - Nurse Practitioner 0941435523 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anderson Physician Alliance IncGroup PAC ID 3274727318, 69 clinicians

Practice addresses (Care Compare)

2024 15TH St
FL 2
Meridian, MS 39301-4130
Phone (601) 553-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
850743MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Medical Associates, PA CurrentSince Oct 9, 2017 Accepting new patients
Anderson Physician Alliance, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Urology Clinic of Meridian, P.a. Current Accepting new patients
Trustcare Primary Care, LLC Past Accepting new patients

Locations

1100 17th Ave
Meridian, MS 39301
Phone (601) 703-1465

1600 22nd Ave
Meridian, MS 39301
Phone (601) 483-5322

2024 15th St
Fl 2
Meridian, MS 39301
Phone (601) 553-2000

2124 14th St
Meridian, MS 39301
Phone (601) 483-8811

2124 14th St
Slp Ctr
Meridian, MS 39301
Phone (601) 553-6466

605 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-6925

Interoperability endpoints

  • Direct secure messaging: cpatrick626708@direct.bmhcc.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1366877268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749215",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749215",
            "telephone_number": "901-226-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 14TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014040",
            "telephone_number": "601-553-6466",
            "fax_number": "601-553-6072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 17th Ave",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393014219",
            "country_code": "US",
            "telephone_number": "601-703-1465",
            "fax_number": "601-703-1467",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2024 15th St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393014130",
            "country_code": "US",
            "telephone_number": "601-553-2000",
            "fax_number": "601-553-6856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "CINDY",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "850743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02850756",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.