Individual provider Active NPI

Lakesha Butler

  • Gerontology Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1437561982
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R883302 Issued in MS
Practice address
845 S Madison St
Tupelo, MS 38801-4905
Phone
(662) 377-2500
Fax
(662) 377-2069
NPI assigned
Jun 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R883302 MS Primary

Addresses

Primary practice location

845 S Madison St
Tupelo, MS 38801-4905

Mailing address

845 S Madison St
Tupelo, MS 38801-4905
Phone (662) 377-2500

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
I20141009001077 MS Practitioner - Nurse Practitioner 5092935304 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Mississippi Medical Center, Inc.Group PAC ID 9931010600, 361 clinicians

Practice addresses (Care Compare)

410 Council Cir
Tupelo, MS 38801-4938
Phone (662) 377-2500

Hospital & facility affiliations

  • North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004
  • Pontotoc Health Service Inc Cah Hospital, Pontotoc, MS, CCN 251308
  • Webster General Hospital/ Swing Bed Hospital, Eupora, MS, CCN 250020
  • North Mississippi Medical Center-Gilmore Amory Hospital, Amory, MS, CCN 250025
  • Clay County Medical Corporation Hospital, West Point, MS, CCN 250067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R883302MSMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Medical Center, Inc. CurrentSince Aug 22, 2022 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Clinics Inc CurrentSince Jun 25, 2014 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Aug 22, 2022 Accepting new patients
North Mississippi Medical Clinics Inc CurrentSince Jun 25, 2014 Accepting new patients
Amory Surgery Clinic, PLLC Past Accepting new patients

Locations

410 Council Cir
Tupelo, MS 38801
Phone (662) 377-2500

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: lakeshabutler@nmhs.medalliesdirect.net

Organizations & group practices 7

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.

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": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1437561982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014905",
            "telephone_number": "662-377-2500",
            "fax_number": "662-377-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014905",
            "telephone_number": "662-377-2500",
            "fax_number": "662-377-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "LAKESHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-02",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "R883302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.