Active NPI
Nikii Vales, LPN
- Licensed Practical Nurse
- Southaven, MS
National Provider Identifier
1861079402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 56703
- Practice address
- 340 Stateline Rd W
Southaven, MS 38671-1610 - Phone
- (877) 969-2157
- NPI assigned
- Mar 29, 2021
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 56703 | TN | Primary |
Addresses
Primary practice location
340 Stateline Rd W
Southaven, MS 38671-1610
Mailing address
4016 Macaulay CV
Memphis, TN 38127-3937
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | SOUTHAVEN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616976000000",
"number": "1861079402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4016 MACAULAY CV",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381273937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 STATELINE RD W",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386711610",
"telephone_number": "877-969-2157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALES",
"first_name": "NIKII",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-29",
"last_updated": "2021-03-29",
"certification_date": "2021-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "TN",
"license": "56703",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "SOUTHAVEN",
"affiliation": "N",
"address_1": "340 Stateline Rd W",
"city": "Southaven",
"state": "MS",
"country_code": "US",
"postal_code": "386711610",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.