Lacona Blunt, MSN, APRN, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Corinth, MS
NPI 1770173049 · NPPES record last updated Jan 21, 2021
Key facts
- NPI
- 1770173049
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 904398 (MS)
- Practice address
- 303 N Madison St
Corinth, MS 38834-5072 - Phone
- (662) 214-6820
- NPI assigned
- Jan 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Region IV Mental Health Services
Practice addresses (Care Compare)
1213 Maria LN
Iuka, MS 38852-1135
Phone (662) 423-3332
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210331001025 | MS | Practitioner - Nurse Practitioner | 0547677908 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Magnolia Regional Behavioral Health Services | Current |
Accepting new patients | |
| Region IV Mental Health Services | Current |
Accepting new patients | |
| Magnolia Regional Health Center | Current | Accepting new patients | |
| Region IV Desoto County Pharmacy | Current |
Accepting new patients | |
| Region IV Mental Health Services | Past |
Accepting new patients | |
| Region IV Mental Health Services | Past |
Accepting new patients |
Locations
2100 E Chambers Dr
Booneville, MS 38829
Phone (662) 728-3137
2664 S Harper Rd
Corinth, MS 38834
Phone (662) 287-4055
601 Foote St
Corinth, MS 38834
Phone (662) 287-4424
611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961
2725 Highway 51 S
Hernando, MS 38632
Phone (662) 449-1808
1213 Maria Ln
Iuka, MS 38852
Phone (662) 423-3332
2441A County Road 501
Ripley, MS 38663
Phone (662) 837-8154
Interoperability endpoints
- laconablunt@magnolia.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 904398 | MS | Yes |
Addresses
Primary practice location
303 N Madison St
Corinth, MS 38834-5072
Mailing address
303 N Madison St
Corinth, MS 38834-5072
Phone (662) 214-6820
Other practice location 1
611 Alcorn Dr
Corinth, MS 38834-9388
Phone (662) 293-1000
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.regionivmhs.com | ||
| Other URL | www.mrhc.org |
Other providers in Corinth, MS
- Lindsay Bishop
- Hayley Alyssa Black
- Stephen H. Blair III
- Blavo Medical Group
- Alan Lee Blunt
- Boa Vida Hospital of Aberdeen, Ms, LLC
- Boa Vida Hospital of Aberdeen, Ms, LLC
- Chelsey Brooke Bobo
- Walker Daniel Bobo
- Kelli Boggan
All providers in Corinth, MS · Psychiatric/Mental Health Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.