Individual provider Active NPI

Karen Creel Ladnier, AGACNP

  • Acute Care Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1750888129
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
902645 Issued in MS
Practice address
415 S 28TH Ave
Hattiesburg, MS 39401
Phone
(601) 268-5650
Fax
(601) 579-5240
NPI assigned
Apr 11, 2018
Last updated
Jun 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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 902645 MS Primary

Addresses

Primary practice location

415 S 28TH Ave
Hattiesburg, MS 39401

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 268-5650

Other identifiers 1

IdentifierTypeStateIssuer
01882011MedicaidMS

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
I20180710003229 MS Practitioner - Nurse Practitioner 2062768708 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Relias Emergency Medicine Specialists of Hattiesburg LLCGroup PAC ID 9032549142, 46 clinicians
Wayne General HospitalGroup PAC ID 2668457581, 47 clinicians

Practice addresses (Care Compare)

6051 U S Hwy 49
Hattiesburg, MS 39401-7200
Phone (601) 288-7000

950 Matthew Dr
Waynesboro, MS 39367-2567
Phone (601) 735-5151

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
902645MSMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne General Hospital Current Accepting new patients
Relias Emergency Medicine Specialists of Hattiesburg LLC CurrentSince Apr 18, 2022 Accepting new patients
Wayne General Hospital CurrentSince Apr 1, 2024 Accepting new patients
Wayne General Hospital CurrentSince Apr 1, 2024 Accepting new patients
Hattiesburg Clinic PA CurrentSince Jun 13, 2018 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Jun 13, 2018 Accepting new patients
Wayne General Hospital Past Accepting new patients
Wayne General Hospsital Past Accepting new patients
Wayne General Hospital Past Accepting new patients

Locations

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

940 Matthew Dr
Ste 5
Waynesboro, MS 39367
Phone (601) 735-7285

950 Matthew Dr
Waynesboro, MS 39367
Phone (601) 735-5151

Organizations & group practices 9

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 2

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": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1750888129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5650",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39401",
            "telephone_number": "601-268-5650",
            "fax_number": "601-579-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADNIER",
        "first_name": "KAREN",
        "middle_name": "CREEL",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "902645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01882011",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.