Individual provider Active NPI

Yannique Danyelle Criglar

  • Licensed Practical Nurse
  • Jackson, MS
National Provider Identifier
1710635859
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
324508 Issued in MS
Practice address
200 S Lamar St Ste N400
Jackson, MS 39201-4013
Phone
(601) 604-3260
NPI assigned
Mar 17, 2022
Last updated
Mar 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 324508 MS Primary

Addresses

Primary practice location

200 S Lamar St Ste N400
Jackson, MS 39201-4013

Mailing address

1521 N Hills St
Meridian, MS 39305-1730
Phone (601) 604-3260

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL footprintshomecareinc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
324508MSMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1710635859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 N HILLS ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393051730",
            "telephone_number": "601-604-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S LAMAR ST STE N400",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392014013",
            "telephone_number": "601-604-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIGLAR",
        "first_name": "YANNIQUE",
        "middle_name": "DANYELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MS",
            "license": "324508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "footprintshomecareinc.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "200 S LaMar St Ste N400",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392014013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.