Individual provider Active NPI

Lisa Akridge, NP

  • Nurse Practitioner
  • Waynesboro, MS
National Provider Identifier
1720619083
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
903791 Issued in MS
Practice address
951 Matthew Dr Ste a
Waynesboro, MS 39367-2566
Phone
(601) 735-2401
Fax
(601) 735-5205
NPI assigned
Jan 27, 2020
Last updated
Jan 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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 903791 MS Primary

Addresses

Primary practice location

951 Matthew Dr Ste a
Waynesboro, MS 39367-2566

Mailing address

951 Matthew Dr Ste a
Waynesboro, MS 39367-2566
Phone (601) 735-2401

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
I20200309000074 MS Practitioner - Nurse Practitioner 3870921711 Reassigns benefits to 1 organization

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
Wayne General HospitalGroup PAC ID 2668457581, 47 clinicians

Practice addresses (Care Compare)

951 Matthew Dr
Suite a
Waynesboro, MS 39367-2566
Phone (601) 735-2401

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
903791MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne General Hospital Current Accepting new patients
Wayne General Hospital CurrentSince Jan 1, 2020 Accepting new patients
Wayne General Hospital CurrentSince Jan 1, 2020 Accepting new patients
Wayne General Hospital Past Accepting new patients
Wayne General Hospsital Past Accepting new patients

Locations

1325 Azalea Dr
Waynesboro, MS 39367
Phone (601) 671-2825

951 Matthew Dr
Ste A
Waynesboro, MS 39367
Phone (601) 735-2401

Organizations & group practices 5

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": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1720619083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 MATTHEW DR STE A",
            "city": "WAYNESBORO",
            "state": "MS",
            "postal_code": "393672566",
            "telephone_number": "601-735-2401",
            "fax_number": "601-735-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 MATTHEW DR STE A",
            "city": "WAYNESBORO",
            "state": "MS",
            "postal_code": "393672566",
            "telephone_number": "601-735-2401",
            "fax_number": "601-735-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKRIDGE",
        "first_name": "LISA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "903791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, MS

Sources for this page

Verify at the official NPI Registry.