Individual provider Active NPI

M'Tajia Altman, FNP-C

  • Primary Care Nurse Practitioner
  • Flowood, MS
National Provider Identifier
1831909159
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
906810 Issued in MS
Practice address
4814 Lakeland Dr
Flowood, MS 39232-8694
Phone
(601) 414-0730
NPI assigned
Jan 9, 2025
Last updated
Jan 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 906810 MS Primary

Addresses

Primary practice location

4814 Lakeland Dr
Flowood, MS 39232-8694

Mailing address

53 Northtown Dr Apt 32X
Jackson, MS 39211-3802

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
I20250603004465 MS Practitioner - Nurse Practitioner 3173032844 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
906810MSMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony House Calls LLC CurrentSince Mar 23, 2025 Accepting new patients

Locations

4814 Lakeland Dr
Flowood, MS 39232
Phone (601) 414-0730

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1831909159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 NORTHTOWN DR APT 32X",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4814 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328694",
            "telephone_number": "601-414-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTMAN",
        "first_name": "M'TAJIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "906810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

Verify at the official NPI Registry.