Individual provider Active NPI

Randi April Watkins, FNP

  • Family Nurse Practitioner
  • Carthage, MS
National Provider Identifier
1669635926
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R858535 Issued in MS
Practice address
407 S Valley St
Carthage, MS 39051-4051
Phone
(601) 298-0333
NPI assigned
Jul 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

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 R858535 MS Primary

Addresses

Primary practice location

407 S Valley St
Carthage, MS 39051-4051

Mailing address

PO Box 23996
Jackson, MS 39225-3996
Phone (601) 206-6100

Other identifiers 1

IdentifierTypeStateIssuer
09809517MedicaidMS

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
I20080805000622 MS Practitioner - Nurse Practitioner 1557435872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Mississippi School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Medical Group of Mississippi LLCGroup PAC ID 8729973623, 31 clinicians

Practice addresses (Care Compare)

300 B S Pearl St
Carthage, MS 39051-4108
Phone (601) 298-0333

332 Hwy 12 W
Kosciusko, MS 39090-3209
Phone (662) 289-1800

340 Hwy 12 W
Kosciusko, MS 39090-3209
Phone (662) 289-3588

Hospital & facility affiliations

  • Accentcare Home Health of Carthage Home health agency, Carthage, MS, CCN 257129
  • Mississippi Homecare of Jackson Home health agency, Jackson, MS, CCN 257082
  • Baptist Medical Center-Leake Hospital, Carthage, MS, CCN 251315
  • Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Group of Mississippi LLC CurrentSince Sep 1, 2013 Accepting new patients
Premier Medical Group of Mississippi LLC Past Accepting new patients
Baptist Medical Center-Leake, Inc Past Accepting new patients

Locations

407 S Valley St
Carthage, MS 39051
Phone (601) 298-0333

300 S Pearl St
#B
Carthage, MS 39051
Phone (601) 298-0333

59 Montague St
Goodman, MS 39079
Phone (662) 739-6040

332 Highway 12 W
Kosciusko, MS 39090
Phone (601) 206-6100

530 Veterans Memorial Dr
Kosciusko, MS 39090
Phone (662) 289-9155

Interoperability endpoints

  • Direct secure messaging: randi.watkins.1@27768.direct.athenahealth.com

Organizations & group practices 3

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 4

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1669635926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23996",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253996",
            "telephone_number": "601-206-6100",
            "fax_number": "601-206-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S VALLEY ST",
            "city": "CARTHAGE",
            "state": "MS",
            "postal_code": "390514051",
            "telephone_number": "601-298-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "RANDI",
        "middle_name": "APRIL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R858535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09809517",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, MS

Sources for this page

Verify at the official NPI Registry.