Individual provider Active NPI

Nancy F Easterling, CFNP

  • Nurse Practitioner
  • Columbia, MS
National Provider Identifier
1568486124
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R629626 Issued in MS
Practice address
914 Sumrall Rd
Columbia, MS 39429-2652
Phone
(601) 731-1470
Fax
(601) 731-1474
NPI assigned
Jul 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R629626 MS Primary

Addresses

Primary practice location

914 Sumrall Rd
Columbia, MS 39429-2652

Mailing address

914 Sumrall Rd
Columbia, MS 39429-2652
Phone (601) 731-1470

Other identifiers 1

IdentifierTypeStateIssuer
00117189MedicaidMS

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
I20100708000014 MS Practitioner - Nurse Practitioner 3577694587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine Clinic of Columbia, P.a.Group PAC ID 6507982410, 3 clinicians

Practice addresses (Care Compare)

914 Sumrall Rd
Columbia, MS 39429-2652
Phone (601) 731-1470

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R629626MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Clinic of Columbia, P.a. CurrentSince Dec 9, 2011 Accepting new patients

Locations

914 Sumrall Rd
Columbia, MS 39429
Phone (601) 731-1470

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568486124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 SUMRALL RD",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394292652",
            "telephone_number": "601-731-1470",
            "fax_number": "601-731-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 SUMRALL RD",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394292652",
            "telephone_number": "601-731-1470",
            "fax_number": "601-731-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTERLING",
        "first_name": "NANCY",
        "middle_name": "F",
        "credential": "CFNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R629626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00117189",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MS

Sources for this page

Verify at the official NPI Registry.