Individual provider Active NPI

Stephanie Crosby, WHNP-BC, FNP-C

  • Women's Health Nurse Practitioner
  • Laurel, MS
National Provider Identifier
1447299508
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
R804356 Issued in MS
Practice address
307 S. 13TH Ave
Laurel, MS 39440-4342
Phone
(601) 649-7600
Fax
(601) 649-7628
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R804356 MS Primary

Addresses

Primary practice location

307 S. 13TH Ave
Laurel, MS 39440-4342

Mailing address

307 S. 13TH Ave
Laurel, MS 39440-4342
Phone (601) 649-7600

Other identifiers 1

IdentifierTypeStateIssuer
00126042MedicaidMS

Other names 1

  • Stephanie Nixon Former name

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
I20040616000773 MS Practitioner - Nurse Practitioner 4284618315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Central Clinics, IncGroup PAC ID 4385876655, 117 clinicians

Practice addresses (Care Compare)

1002 Jefferson St
Laurel, MS 39440-4306

1203 Ave B
Ellisville, MS 39437-2080
Phone (601) 477-2226

1220 Jefferson St
Laurel, MS 39440-4355
Phone (601) 399-6169

Hospital & facility affiliations

  • South Central Reg Med Ctr Hospital, Laurel, MS, CCN 250058

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Clinics, Inc Current Accepting new patients
South Central Clinics, Inc CurrentSince Jan 1, 2023 Accepting new patients
South Central Clinics, Inc CurrentSince Jan 1, 2023 Accepting new patients
South Central Clinics, Inc. Past Accepting new patients

Locations

1203 B Ave
Ellisville, MS 39437
Phone (601) 477-8553

1008 N 15th Ave
Laurel, MS 39440
Phone (601) 426-5125

Interoperability endpoints

  • Direct secure messaging: scrosby@wfc.gwaydirect.com

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.

Hospital & facility affiliations 1

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1447299508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S. 13TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404342",
            "telephone_number": "601-649-7600",
            "fax_number": "601-649-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S. 13TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404342",
            "telephone_number": "601-649-7600",
            "fax_number": "601-649-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSBY",
        "first_name": "STEPHANIE",
        "credential": "WHNP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MS",
            "license": "R804356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126042",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "NIXON",
            "credential": "WHNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.