Individual provider Active NPI

Elizabeth Allen, NP

  • Family Nurse Practitioner
  • Laurel, MS
National Provider Identifier
1659918084
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903499 Issued in MS
Practice address
1220 Jefferson St
Laurel, MS 39440-4355
Phone
(601) 426-4000
NPI assigned
Dec 4, 2019
Last updated
Dec 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 903499 MS Primary

Addresses

Primary practice location

1220 Jefferson St
Laurel, MS 39440-4355

Mailing address

PO Box 247
Laurel, MS 39441-0247
Phone (601) 399-6169

Other practice location 1

1430 Jefferson St
Laurel, MS 39440-4243
Phone (601) 425-2273

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
I20200113000850 MS Practitioner - Nurse Practitioner 1052746435 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FGH Physician BillingGroup PAC ID 1850344946, 27 clinicians

Practice addresses (Care Compare)

6051 U S Hwy 49
Hattiesburg, MS 39401-7200
Phone (601) 288-2474

801 Goodyear Blvd
Picayune, MS 39466-3221
Phone (601) 749-0688

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
903499MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Clinics, Inc CurrentSince Dec 9, 2019 Accepting new patients
FGH Physician Billing CurrentSince Mar 5, 2021 Accepting new patients
South Central Clinics, Inc CurrentSince Dec 9, 2019 Accepting new patients
Hattiesburg Clinic PA CurrentSince Aug 12, 2020 Accepting new patients
South Central Clinics, Inc Current Accepting new patients
Hattiesburg Clinic, PA CurrentSince Aug 12, 2020 Accepting new patients

Locations

1203 B Ave
Ellisville, MS 39437
Phone (601) 477-8553

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

1220 Jefferson St
Laurel, MS 39440
Phone (601) 426-4000

1430 Jefferson St
Laurel, MS 39440
Phone (601) 425-2273

801 Goodyear Blvd
Picayune, MS 39466
Phone (601) 749-0688

Interoperability endpoints

  • Direct secure messaging: eallen102685@directpatientrecord.com

Organizations & group practices 6

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 1

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": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1659918084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410247",
            "telephone_number": "601-399-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404355",
            "telephone_number": "601-426-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MS",
            "postal_code": "394404243",
            "country_code": "US",
            "telephone_number": "601-425-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-04",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.