Individual provider Active NPI

Carey Leigh Norris, FNP

  • Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1740413764
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R870159 Issued in MS
Practice address
7100 U S Highway 98 Ste 220
Hattiesburg, MS 39402-8557
Phone
(601) 582-7655
Fax
(601) 450-2441
NPI assigned
Aug 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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 R870159 MS Primary

Addresses

Primary practice location

7100 U S Highway 98 Ste 220
Hattiesburg, MS 39402-8557

Mailing address

7100 U S Highway 98 Ste 220
Hattiesburg, MS 39402-8557
Phone (601) 582-7655

Other identifiers 2

IdentifierTypeStateIssuer
9055452OtherMSAETNA
08327830MedicaidMS

Other names 1

  • Carey Leigh Revels Former name

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
I20091022000268 MS Practitioner - Nurse Practitioner 5395882419 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R870159MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis Associates, PLLC CurrentSince Jun 30, 2021 Accepting new patients

Locations

7100 U S Highway 98
Ste 220
Hattiesburg, MS 39402
Phone (601) 582-7655

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1740413764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 U S HIGHWAY 98 STE 220",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028557",
            "telephone_number": "601-582-7655",
            "fax_number": "601-450-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 U S HIGHWAY 98 STE 220",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028557",
            "telephone_number": "601-582-7655",
            "fax_number": "601-450-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "CAREY",
        "middle_name": "LEIGH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R870159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9055452",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08327830",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAREY",
            "last_name": "REVELS",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.