Individual provider Active NPI

Robert Steven Harvey, AGACNP

  • Acute Care Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1740664127
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R886819 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-5065
Fax
(601) 984-2962
NPI assigned
Jul 15, 2015
Last updated
Mar 22, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R886819 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

2500 N State St
Jackson, MS 39216-4500
Phone (601) 214-2837

Other identifiers 3

IdentifierTypeStateIssuer
04558033MedicaidMS
P01788016OtherMSRAILROAD MEDICARE
194481MedicaidMS

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
I20150912000082 MS Practitioner - Nurse Practitioner 5698082386 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R886819MSMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 5, 2015 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 5, 2015 Accepting new patients

Locations

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

2500 N State St
Rm 2525
Jackson, MS 39216
Phone (601) 984-1530

239 Bowling Green Rd
Lexington, MS 39095
Phone (662) 834-1321

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1740664127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-214-2837",
            "fax_number": "601-815-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5065",
            "fax_number": "601-984-2962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARVEY",
        "first_name": "ROBERT",
        "middle_name": "STEVEN",
        "name_prefix": "Mr.",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-15",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "R886819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04558033",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01788016",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194481",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.