NPIMap

Organization Active NPI

Lumley Health Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brookhaven, MS
National Provider Identifier
1497413330
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LUMLEY HEALTH SERVICES LLC
Practice address
106 Brady Dr
Brookhaven, MS 39601-3738
Phone
(601) 754-9411
NPI assigned
Dec 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Authorized official

Name
Missi Robinson
Title
Credentialing Specialist
Phone
(601) 248-7135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

106 Brady Dr
Brookhaven, MS 39601-3738

Mailing address

327 N Jackson St
Brookhaven, MS 39601-3041
Phone (601) 754-9411

Other identifiers 1

IdentifierTypeStateIssuer
02232862MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211222000575 MS Part B Supplier - Clinic/Group Practice 8628469962 Receives reassigned benefits from 1 practitioner
Practice locations: Brookhaven, MS

National Provider Directory

National Provider Directory

Locations

327 N Jackson St
Brookhaven, MS 39601
Phone (601) 754-9411

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1497413330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 N JACKSON ST",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013041",
            "telephone_number": "601-754-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 BRADY DR",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013738",
            "telephone_number": "601-754-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMLEY HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-07",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "MISSI",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "601-248-7135"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02232862",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.