Individual provider Active NPI

Lavechelle Pillers, FNP

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1477023596
Registry record updated Dec 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
901938 Issued in MS
Practice address
5140 Galaxie Dr Ste 105
Jackson, MS 39206-4354
Phone
(601) 300-3935
NPI assigned
Dec 1, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 901938 MS Primary

Addresses

Primary practice location

5140 Galaxie Dr Ste 105
Jackson, MS 39206-4354

Mailing address

15 Jennifer CT
Madison, MS 39110-8898
Phone (769) 798-0729

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
I20220121001259 MS Practitioner - Nurse Practitioner 8820323447 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
901938MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Claiborne County Hospital Current Accepting new patients
Claiborne County Hospital Current Accepting new patients
Claiborne County Hospital Single Specialty CurrentSince Jan 13, 2022 Accepting new patients
Claiborne County Hospital CurrentSince Jan 13, 2022 Accepting new patients
Claib Cty HSP Pro Fees Past Accepting new patients
Harmony House Calls LLC Single Specialty Past Accepting new patients

Locations

123 McComb Ave
Port Gibson, MS 39150
Phone (601) 437-5141

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543622400000",
    "number": "1477023596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 JENNIFER CT",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108898",
            "telephone_number": "769-798-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 GALAXIE DR STE 105",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064354",
            "telephone_number": "601-300-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILLERS",
        "first_name": "LAVECHELLE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-01",
        "last_updated": "2018-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.