Individual provider Active NPI

Cynthia Pearson, FNP

  • Nurse Practitioner
  • Corinth, MS
National Provider Identifier
1689681942
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R851921 Issued in MS
Practice address
123 Alcorn Dr
Corinth, MS 38834-9359
Phone
(662) 286-2866
Fax
(662) 286-2864
NPI assigned
Aug 1, 2006
Last updated
Jun 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R851921 MS Primary

Addresses

Primary practice location

123 Alcorn Dr
Corinth, MS 38834-9359

Mailing address

P.O. Box 298
Florence, AL 35631-0298
Phone (256) 767-7494

Other identifiers 2

IdentifierTypeStateIssuer
06430512MedicaidMS
2656050MedicaidMS

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
I20081028000519 MS Practitioner - Nurse Practitioner 5294893780 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R851921MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Corinth Medical Specialists CurrentSince Nov 11, 2018 Accepting new patients

Locations

3301 Tinin Dr
Corinth, MS 38834
Phone (662) 665-9111

Interoperability endpoints

  • Direct secure messaging: cynthiapearson@cmsllc.allscriptsdirect.net

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1689681942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 298",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356310298",
            "telephone_number": "256-767-7494",
            "fax_number": "256-765-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349359",
            "telephone_number": "662-286-2866",
            "fax_number": "662-286-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "CYNTHIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R851921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06430512",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2656050",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.