Individual provider Active NPI

Lacey Ann Gullick-Joiner, CNP

  • Family Nurse Practitioner
  • Batesville, MS
National Provider Identifier
1831524909
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
877500 Issued in MS
Practice address
107 Eureka St
Batesville, MS 38606-2599
Phone
(662) 563-7681
Fax
(662) 563-8911
NPI assigned
Sep 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R877500 MS
Family Nurse Practitioner 363LF0000X 877500 MS Primary

Addresses

Primary practice location

107 Eureka St
Batesville, MS 38606-2599

Mailing address

107 Eureka St
Batesville, MS 38606-2599
Phone (662) 563-7681

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
I20151105000197 MS Practitioner - Nurse Practitioner 8426368325 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Batesville Clinic, P.a. 5 clinicians
State of Mississippi - University of Mississippi Medical Center 956 clinicians

Practice addresses (Care Compare)

107 Eureka St
Batesville, MS 38606-2533
Phone (662) 563-7681

107 Eureka St B
Ummc Medical Clinic Batesville
Batesville, MS 38606-2533
Phone (601) 815-2005

Hospital & facility affiliations

  • University of Mississippi Medical Center- Grenada Hospital, Grenada, MS, CCN 250168

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
877500MSMDFamily Nurse Practitioner
R877500MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Batesville Clinic, P.a. CurrentSince Sep 8, 2020 Accepting new patients
Downtown Family Clinic CurrentSince Mar 31, 2024 Accepting new patients
Redmed, LLC CurrentSince Sep 14, 2018 Accepting new patients
Redmed, LLC CurrentSince Sep 14, 2018 Accepting new patients

Locations

107 Eureka St
Batesville, MS 38606
Phone (662) 563-6000

107 Eureka St
#B
Batesville, MS 38606

137 Public Sq
Batesville, MS 38606
Phone (662) 299-1390

12 Brookes Crossing
Pontotoc, MS 38863
Phone (662) 489-4044

105A Quality Ln
Senatobia, MS 38668
Phone (662) 298-2144

Organizations & group practices 27

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.

View all 27

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": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1831524909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 EUREKA ST",
            "city": "BATESVILLE",
            "state": "MS",
            "postal_code": "386062599",
            "telephone_number": "662-563-7681",
            "fax_number": "662-563-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 EUREKA ST",
            "city": "BATESVILLE",
            "state": "MS",
            "postal_code": "386062599",
            "telephone_number": "662-563-7681",
            "fax_number": "662-563-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLICK-JOINER",
        "first_name": "LACEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-09",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R877500",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "877500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, MS

Sources for this page

Verify at the official NPI Registry.