Active NPI
Poplarville Special Separate Municipal School District
- School Registered Nurse
- Poplarville, MS
National Provider Identifier
1740495373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- R859077
- Legal business name
- POPLARVILLE SPECIAL SEPARATE MUNICIPAL SCHOOL DISTRICT
- Practice address
- 804 S Julia St
Poplarville, MS 39470-3017 - Phone
- (601) 795-8477
- Fax
- (601) 795-0712
- NPI assigned
- May 14, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Louise Smith
- Title
- Support Staff Specialist
- Phone
- (601) 795-8477
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | R859077 | MS | Primary |
Addresses
Primary practice location
804 S Julia St
Poplarville, MS 39470-3017
Mailing address
804 S Julia St
Poplarville, MS 39470-3017
Phone (601) 795-8477
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09016077 | Medicaid | MS |
Other names 1
- Poplarville Lower Elementary EPSDT Clinic
National Provider Directory
National Provider Directory- Tax ID family
- Poplarville Lower Elementary Epsdt Clinic
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- School Registered Nurse
- Lumberton, MS
- NPI 1871702035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1740495373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 S JULIA ST",
"city": "POPLARVILLE",
"state": "MS",
"postal_code": "394703017",
"telephone_number": "601-795-8477",
"fax_number": "601-795-0712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 S JULIA ST",
"city": "POPLARVILLE",
"state": "MS",
"postal_code": "394703017",
"telephone_number": "601-795-8477",
"fax_number": "601-795-0712"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "POPLARVILLE SPECIAL SEPARATE MUNICIPAL SCHOOL DISTRICT",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-14",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "LOUISE",
"authorized_official_title_or_position": "SUPPORT STAFF SPECIALIST",
"authorized_official_telephone_number": "601-795-8477",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Registered Nurse, School",
"state": "MS",
"license": "R859077",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09016077",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Poplarville Lower Elementary EPSDT Clinic",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Poplarville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.