Individual provider Active NPI

Hayden Van Norman

  • Student in an Organized Health Care Education/Training Program
  • Clinton, MS
National Provider Identifier
1457187478
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
106 Clinton Pkwy
Clinton, MS 39056-4730
Phone
(601) 925-7374
NPI assigned
Sep 9, 2024
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MS Primary

Addresses

Primary practice location

106 Clinton Pkwy
Clinton, MS 39056-4730

Mailing address

2945 Beaumont CV
Pearl, MS 39208-5324

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
I20251126000227 MS Practitioner - Physician Assistant 0840782876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11605 Southfork Ave
Suite B
Baton Rouge, LA 70816-5220

2945 Beaumont CV
Pearl, MS 39208-5324

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vicksburg Hma Physician Management LLC Current Accepting new patients
Medical Associates of Vicksburg PLLC CurrentSince Oct 28, 2025 Accepting new patients
Vicksburg Hma Physician Management LLC Past Accepting new patients

Locations

2080 S Frontage Rd
Ste 100
Vicksburg, MS 39180
Phone (601) 262-1000

Organizations & group practices 3

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 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": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1457187478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 BEAUMONT CV",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392085324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CLINTON PKWY",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564730",
            "telephone_number": "601-925-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN NORMAN",
        "first_name": "HAYDEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MS

Sources for this page

Verify at the official NPI Registry.