Individual provider Active NPI

Nicole Lott, FNP-C

  • Family Nurse Practitioner
  • Laurel, MS
National Provider Identifier
1861809402
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R882086 Issued in MS
Practice address
235 S 14TH Ave
Laurel, MS 39440-4227
Phone
(601) 651-2830
Fax
(601) 651-2835
NPI assigned
Jul 15, 2014
Last updated
Feb 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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 R882086 MS Primary

Addresses

Primary practice location

235 S 14TH Ave
Laurel, MS 39440-4227

Mailing address

235 S 14TH Ave
Laurel, MS 39440-4227
Phone (601) 651-2830

Other identifiers 1

IdentifierTypeStateIssuer
01929768MedicaidMS

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
I20140917002925 MS Practitioner - Nurse Practitioner 8628297959 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covington County HospitalGroup PAC ID 4183517253, shared by 16 NPIs, 44 clinicians

Practice addresses (Care Compare)

104 W Main St
20 Family Care Seminary
Seminary, MS 39479-9027
Phone (601) 722-3610

3275 Hwy 49 E
Family Care Express
Collins, MS 39428-3776
Phone (601) 765-6292

603 S Main St
Green Tree Family Medical Clinic
Mt Olive, MS 39119-8902
Phone (601) 797-3405

800 3Rd St SW
Magee, MS 39111-3951
Phone (601) 849-1918

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R882086MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covington County Hospital CurrentSince Apr 22, 2017 Accepting new patients
Covington County Hospital CurrentSince Apr 22, 2017 Accepting new patients
Thomas R. Blackledge, Jr., MD, PA Current Accepting new patients
Covington County Hospital CurrentSince Apr 22, 2017 Accepting new patients
Covington County Hospital CurrentSince Oct 29, 2024 Accepting new patients
Covington County Hospital CurrentSince Oct 29, 2019 Accepting new patients
Green Tree Family Medical Clinic Current Accepting new patients
Dearman Medical Group, LLC Past Accepting new patients
Jones Family Medicine Clinic, PLLC Past Accepting new patients

Locations

3275 Highway 49
Ste E
Collins, MS 39428
Phone (601) 765-6292

701 S Holly Ave
Collins, MS 39428
Phone (601) 765-3180

800 3rd St SW
Magee, MS 39111
Phone (601) 849-1918

Organizations & group practices 9

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": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1861809402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 S 14TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404227",
            "telephone_number": "601-651-2830",
            "fax_number": "601-651-2835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 S 14TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404227",
            "telephone_number": "601-651-2830",
            "fax_number": "601-651-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOTT",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R882086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01929768",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.