Active NPI
Ashli Richardson Vandiver
- Family Nurse Practitioner
- Iuka, MS
National Provider Identifier
1619891306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 908674
- Practice address
- 1507 W Quitman St
Iuka, MS 38852-1132 - Phone
- (662) 423-1000
- NPI assigned
- Aug 6, 2026
- Last updated
- Oct 7, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 908674 | MS | Primary |
Addresses
Primary practice location
1507 W Quitman St
Iuka, MS 38852-1132
Mailing address
585 Poplar Cir
Iuka, MS 38852-7415
Phone (662) 603-4123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 908674 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kelly S Segars MD PC | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1785974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791331200000",
"number": "1619891306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "585 POPLAR CIR",
"city": "IUKA",
"state": "MS",
"postal_code": "388527415",
"telephone_number": "662-603-4123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1507 W QUITMAN ST",
"city": "IUKA",
"state": "MS",
"postal_code": "388521132",
"telephone_number": "662-423-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDIVER",
"first_name": "ASHLI",
"middle_name": "RICHARDSON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-08-06",
"last_updated": "2026-10-07",
"certification_date": "2026-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "908674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iuka, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.