NPIMap

Individual provider Active NPI

Debra B Baxter, FNP-BC

  • Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1811079544
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R852798 Issued in MS
Practice address
14116 Customs Blvd
Gulfport, MS 39503-5164
Phone
(833) 362-6703
NPI assigned
Oct 20, 2006
Last updated
Dec 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A004596 AR
Nurse Practitioner 363L00000X R852798 MS Primary

Addresses

Primary practice location

14116 Customs Blvd
Gulfport, MS 39503-5164

Mailing address

2918 Louis Sessions St
Lake Village, AR 71653-6049
Phone (870) 265-5343

Other practice location 1

2918 Louis Sessions St
Lake Village, AR 71653-6049
Phone (870) 265-5343 ext. 114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041102000450 MS Practitioner - Nurse Practitioner 4486616497 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Segue Health of Mississippi LLCGroup PAC ID 2769757897, 23 clinicians

Practice addresses (Care Compare)

232 Market St
Flowood, MS 39232-3339
Phone 8885512538101

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
17.52 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
58.4

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pascagoula Urgent Care CurrentSince Mar 20, 2018 Accepting new patients
Segue Health of Mississippi LLC CurrentSince Jul 1, 2022 Accepting new patients
United Emergency Services, Inc. Nurse Practitioner Past Accepting new patients
Delta Physician Practices Past Accepting new patients
Camellia Pharmacy Services LLC Past Accepting new patients

Locations

232 Market St
Jackson, MS 39232
Phone (588) 498-6767

2210 Denny Ave
Pascagoula, MS 39567
Phone (228) 372-6040

Interoperability endpoints

  • Direct secure messaging: dbaxter@landmarkhealth-direct.org

Organizations & group practices 7

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1811079544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2918 LOUIS SESSIONS ST",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716536049",
            "telephone_number": "870-265-5343",
            "fax_number": "870-265-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14116 CUSTOMS BLVD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395035164",
            "telephone_number": "833-362-6703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2918 Louis Sessions St",
            "address_purpose": "LOCATION",
            "city": "Lake Village",
            "state": "AR",
            "postal_code": "716536049",
            "country_code": "US",
            "telephone_number": "870-265-5343 x114",
            "fax_number": "870-265-5686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAXTER",
        "first_name": "DEBRA",
        "middle_name": "B",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A004596",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R852798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.