Individual provider Active NPI

Heather Johnson Harden, C.F.N.P.

  • Family Nurse Practitioner
  • Liberty, MS
National Provider Identifier
1861428716
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R862562 Issued in MS
Practice address
138 Clinic Drive
Liberty, MS 39645
Phone
(601) 657-8091
Fax
(601) 657-8873
NPI assigned
Jun 23, 2006
Last updated
Feb 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R862562 MS Primary

Addresses

Primary practice location

138 Clinic Drive
Liberty, MS 39645

Mailing address

3815A Smylie Rd
Liberty, MS 39645-8249
Phone (601) 657-1277

Other identifiers 1

IdentifierTypeStateIssuer
02323888MedicaidMS

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
I20060306000415 MS Practitioner - Nurse Practitioner 3274549894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Mississippi Ear Nose and Throat Clinic PAGroup PAC ID 0244330686, 4 clinicians

Practice addresses (Care Compare)

405 Marion Ave
McComb, MS 39648-2709
Phone (601) 684-1250

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R862562MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amite County Medical Services, Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1861428716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815A SMYLIE RD",
            "city": "LIBERTY",
            "state": "MS",
            "postal_code": "396458249",
            "telephone_number": "601-657-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 CLINIC DRIVE",
            "city": "LIBERTY",
            "state": "MS",
            "postal_code": "39645",
            "telephone_number": "601-657-8091",
            "fax_number": "601-657-8873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEN",
        "first_name": "HEATHER",
        "middle_name": "JOHNSON",
        "name_prefix": "Mrs.",
        "credential": "C.F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R862562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02323888",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MS

Sources for this page

Verify at the official NPI Registry.