Individual provider Active NPI

Sharon Cranford Easterling, GNP-BC

  • Gerontology Nurse Practitioner
  • Collins, MS
National Provider Identifier
1750728648
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R655104 Issued in MS
Practice address
701 S Holly Ave
Collins, MS 39428-3894
Phone
(601) 722-3610
Fax
(601) 722-9985
NPI assigned
May 31, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R655104 MS Primary

Addresses

Primary practice location

701 S Holly Ave
Collins, MS 39428-3894

Mailing address

701 S Holly Ave
Collins, MS 39428-3894
Phone (601) 722-3610

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
I20190520001094 MS Practitioner - Nurse Practitioner 5799028528 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R655104MSMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Homedica of Louisiana, LLC CurrentSince Nov 1, 2019 Accepting new patients
Homedica of Mississippi, LLC PastSince Jul 25, 2021 Accepting new patients

Locations

1240 Broad Ave
Ste B
Gulfport, MS 39501
Phone (601) 456-5100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1750728648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S HOLLY AVE",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394283894",
            "telephone_number": "601-722-3610",
            "fax_number": "601-722-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S HOLLY AVE",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394283894",
            "telephone_number": "601-722-3610",
            "fax_number": "601-722-9985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTERLING",
        "first_name": "SHARON",
        "middle_name": "CRANFORD",
        "name_prefix": "Mrs.",
        "credential": "GNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-31",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "R655104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collins, MS

Sources for this page

Verify at the official NPI Registry.