Innovative Healthcare Management LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

INNOVATIVE HEALTHCARE MANAGEMENT LLC

Practice address

3078 Highway 98 E
McComb, MS 39648-8267

Phone

(601) 205-9994

Fax

(480) 478-0633

NPI assigned

Jul 24, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Katrina Maria Dryer, CFNPNPI 1124068952

Title

Nurse Practitioner

Phone

(480) 478-0520

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ, MS2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katrina Dryer, NP

  • Family Nurse Practitioner
  • Peoria, AZ
  • NPI 1124068952

  MS

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1861622722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2049",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396492049",
            "telephone_number": "480-478-0520",
            "fax_number": "480-478-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3078 HIGHWAY 98 E",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396488267",
            "telephone_number": "601-205-9994",
            "fax_number": "480-478-0633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20860 N Tatum Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850504283",
            "country_code": "US",
            "telephone_number": "480-478-0520",
            "fax_number": "480-478-0633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INNOVATIVE HEALTHCARE MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-24",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "DRYER",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "480-478-0520",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CFNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320915",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z131830",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Hunt
• Kimberly Hurst
• Yvonne Denise Hutto, FNP-C
• James D Hux, RPH
• Inner Peace Living, Inc
• Innovative Pharmacy Services Inc (Guy's Innovative Pharmacy Vital Care)
• Inspired Healthcare Staffing LLC
• John Mark Irby, FNP
• Megan Ivy Jones
• Jackson Vamc

• Family Nurse Practitioner in McComb, MS
• Providers in McComb, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.