Individual provider Active NPI

Julie Vansice, CFNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1568554582
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R710539 Issued in MS
Practice address
969 Lakeland Dr
St. Thomas Hall
Jackson, MS 39216-4606
Phone
(601) 200-3110
Fax
(601) 200-3109
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R710539 MS Primary

Addresses

Primary practice location

969 Lakeland Dr
St. Thomas Hall
Jackson, MS 39216-4606

Mailing address

PO Box 23666
Jackson, MS 39225-3666
Phone (601) 200-3110

Other identifiers 1

IdentifierTypeStateIssuer
08259846MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20140214000692 AL Practitioner - Nurse Practitioner 0648284166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mental Health BD of Bibb Pickens and Tuscaloosa CountiesGroup PAC ID 6608861638, 7 clinicians

Practice addresses (Care Compare)

3500 Skyland Blvd E
Tuscaloosa, AL 35405-4558
Phone (205) 391-3131

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R710539MSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health BD of Bibb Pickens and Tuscaloosa Counties CurrentSince Sep 2, 2017 Accepting new patients
Cahaba Center for Mental Health and Mental Retardation CurrentSince Nov 9, 2013 Accepting new patients
St. Dominic Medical Associates LLC Past Accepting new patients
St. Dominic Medical Associates LLC Past Accepting new patients

Locations

1017 Medical Center Pkwy
Selma, AL 36701
Phone (334) 875-2100

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299542400000",
    "number": "1568554582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23666",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253666",
            "telephone_number": "601-200-3110",
            "fax_number": "601-200-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "address_2": "ST. THOMAS HALL",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "601-200-3110",
            "fax_number": "601-200-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANSICE",
        "first_name": "JULIE",
        "credential": "CFNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R710539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08259846",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.