Active NPI
Nicole Lynn Payne, CFNP
- Family Nurse Practitioner
- Southaven, MS
National Provider Identifier
1851575138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R870070
- Practice address
- 3451 Goodman Rd E
Suite 115
Southaven, MS 38672-9303 - Phone
- (662) 890-5555
- Fax
- (662) 890-8899
- NPI assigned
- Dec 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R870070 | MS | Primary |
Addresses
Primary practice location
3451 Goodman Rd E
Suite 115
Southaven, MS 38672-9303
Mailing address
4631 Stone Park Blvd
Olive Branch, MS 38654-6983
Phone (662) 873-3467
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3451 Goodman Rd E
Suite 115
Southaven, MS 38672-9304
Phone (662) 890-5555
Hospital & facility affiliations
- Baptist Home Care and Hospice North Mississippi
- Accentcare Home Health of Greenwood
- Baptist Memorial Hospital Desoto
- Methodist Healthcare - Olive Branch Hospital
- Baptist Memorial Hospital
- Methodist Hospitals of Memphis
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stonebridge Medical Group, PLC | Past | Accepting new patients |
Interoperability endpoints
- nicole.payne.1@14940.direct.athenahealth.com
- npayne@fmconm-ms.direct.office.nextgen.com
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Southaven, MS
- NPI 1134174154
-
- Adult Health Nurse Practitioner
- Jackson, TN
- NPI 1487977369
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Southaven, MS
- NPI 1194789818
-
- Home Health Agency
- Batesville, MS
- NPI 1275068959
-
- General Acute Care Hospital
- Olive Branch, MS
- NPI 1912341439
-
- Home Health Agency
- Greenwood, MS
- NPI 1235270588
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1578527172
-
- Children's Hospital
- Memphis, TN
- NPI 1386709871
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1558365890
-
- Children's Hospital
- Germantown, TN
- NPI 1649654450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1851575138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4631 STONE PARK BLVD",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "386546983",
"telephone_number": "662-873-3467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3451 GOODMAN RD E",
"address_2": "SUITE 115",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386729303",
"telephone_number": "662-890-5555",
"fax_number": "662-890-8899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "NICOLE",
"middle_name": "LYNN",
"credential": "CFNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-23",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R870070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.