Lashona Dujuante Mims, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Lyon, MS
NPI 1821877754 · NPPES record last updated Sep 28, 2023
Key facts
- NPI
- 1821877754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 905992 (MS)
- Practice address
- 1216 Berryhill Trailer Park
Lyon, MS 38645-9777 - Phone
- (662) 645-1516
- NPI assigned
- Sep 28, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northwest Miss Regional Medical Center
Practice addresses (Care Compare)
2000 N State St
Suite a
Clarksdale, MS 38614-6100
Phone (662) 627-7361
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 |
|---|---|---|---|---|
| I20260219001006 | MS | Practitioner - Nurse Practitioner | 4082194824 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 905992 | MS | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 905992 | MS | Yes |
Addresses
Primary practice location
1216 Berryhill Trailer Park
Lyon, MS 38645-9777
Mailing address
1216 Berryhill Trailer Park
Lyon, MS 38645-9777
Phone (662) 645-1516
Other providers in Lyon, MS
All providers in Lyon, 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 Sep 28, 2023. 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.