Individual provider Active NPI

Lucy B Hodges, FPNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenwood, MS
National Provider Identifier
1639331994
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R537179 Issued in MS
Practice address
1303 River Rd
Greenwood, MS 38930-4029
Phone
(662) 299-2809
Fax
(662) 453-3581
NPI assigned
Jun 27, 2008
Last updated
Oct 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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 R537179 MS Primary

Addresses

Primary practice location

1303 River Rd
Greenwood, MS 38930-4029

Mailing address

1303 River Rd
Greenwood, MS 38930-4029
Phone (662) 299-2809

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
I20081226000146 MS Practitioner - Nurse Practitioner 1355403452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

370 Courthouse Rd
Suite 106
Gulfport, MS 39507-1889
Phone (228) 865-1330

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R537179MSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lucy B Hodges RN FPNP PLLC CurrentSince Jan 2, 2012 Accepting new patients
Primesource Nursing Services, Inc Psychiatric/Mental Health CurrentSince Mar 1, 2021 Accepting new patients
Primesource Nursing Services, Inc Current Accepting new patients
Region VI Community Mental Health Commission PastSince Feb 1, 2012 Accepting new patients
Garden Park Past Accepting new patients

Locations

1966 Hill Dr
Grenada, MS 38901
Phone (662) 226-2442

370 Courthouse Rd
Ste 106
Gulfport, MS 39507

Organizations & group practices 5

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": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1639331994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 RIVER RD",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304029",
            "telephone_number": "662-299-2809",
            "fax_number": "662-453-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 RIVER RD",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304029",
            "telephone_number": "662-299-2809",
            "fax_number": "662-453-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "LUCY",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "FPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R537179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, MS

Sources for this page

Verify at the official NPI Registry.