Individual provider Active NPI

Atricia R White, FNP

  • Nurse Practitioner
  • Olive Branch, MS
National Provider Identifier
1558761148
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
19085 Issued in TN
Practice address
9075 Sandidge Center CV
Olive Branch, MS 38654-3514
Phone
(662) 895-4949
Fax
(662) 895-6776
NPI assigned
Sep 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 901277 MS
Nurse Practitioner 363L00000X 19085 TN Primary

Addresses

Primary practice location

9075 Sandidge Center CV
Olive Branch, MS 38654-3514

Mailing address

4833 Back Forty Dr
Olive Branch, MS 38654-8380
Phone (901) 268-2188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
901277MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Olive Branch Family Medical Center CurrentSince Nov 30, 2015 Accepting new patients

Locations

9075 Sandidge Center Cv
Olive Branch, MS 38654
Phone (662) 895-4949

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

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": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1558761148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4833 BACK FORTY DR",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548380",
            "telephone_number": "901-268-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9075 SANDIDGE CENTER CV",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386543514",
            "telephone_number": "662-895-4949",
            "fax_number": "662-895-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ATRICIA",
        "middle_name": "R",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "901277",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "19085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

Verify at the official NPI Registry.