Deborah G Headley, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R748377 Issued in MS

Practice address

971 Lakeland Dr
Suite 1250
Jackson, MS 39216-4643

Phone

(601) 366-1011

Fax

(601) 366-7311

NPI assigned

Oct 20, 2009

Last updated

Oct 20, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Revitalize Hydration Therapy, LLC

  • Gerontology Nurse Practitioner
  • Flowood, MS
  • NPI 1285261123
  Medicare reassignment NPD
• Medical Foundation of Central Ms

  dba Baptist Medical Clinic-Brandon

  • Family Medicine Physician
  • Brandon, MS
  • NPI 1114264264
  NPD (past)

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1720314180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 1250",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-366-1011",
            "fax_number": "601-366-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 1250",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-366-1011",
            "fax_number": "601-366-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADLEY",
        "first_name": "DEBORAH",
        "middle_name": "G",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R748377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE LICENSE",
            "identifier": "R748377",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcia J. Hays, M.S., R.D., CDCES
• Necotis M Hays
• Zachary James Hays, CRNA
• Andrew Richard Hayslett
• Leah Headings, LCSW
• Massie H Headley, MD
• Heal All Wound Care LLC
• Heal Thy Self Counseling Services, LLC (Dr. Dorothy Smith, LCSW)
• Healing in the Truth Therapy
• Healsafe Wound Clinic

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.