Organization Active NPI

Denesia Y Giffin PLLC

  • Family Nurse Practitioner
  • Vicksburg, MS
National Provider Identifier
1659739787
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
748148 Issued in MS
Legal business name
DENESIA Y GIFFIN PLLC
Practice address
1901 Mission 66
Vicksburg, MS 39180-3711
Phone
(601) 636-0097
Fax
(601) 629-9969
NPI assigned
Feb 3, 2016
Last updated
Feb 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Authorized official

Name
Bill Fulcher
Title
Adm
Phone
(601) 636-0097

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 748148 MS Primary

Addresses

Primary practice location

1901 Mission 66
Vicksburg, MS 39180-3711

Mailing address

1901 Mission 66
Vicksburg, MS 39180-3711
Phone (601) 636-0097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160323000426 MS Part B Supplier - Clinic/Group Practice 3274830021 Receives reassigned benefits from 1 practitioner
Practice locations: Vicksburg, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454457600000",
    "number": "1659739787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 MISSION 66",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391803711",
            "telephone_number": "601-636-0097",
            "fax_number": "601-629-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MISSION 66",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391803711",
            "telephone_number": "601-636-0097",
            "fax_number": "601-629-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENESIA Y GIFFIN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-03",
        "last_updated": "2016-02-03",
        "status": "A",
        "authorized_official_last_name": "FULCHER",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "ADM",
        "authorized_official_telephone_number": "601-636-0097"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "748148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.