Individual provider Active NPI

Natasha Yvonneavion West, FNP-C

  • Family Nurse Practitioner
  • Vicksburg, MS
National Provider Identifier
1871992818
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R884978 Issued in MS
Practice address
2100 Highway 61 N
Vicksburg, MS 39183-8211
Phone
(601) 883-5000
NPI assigned
Aug 15, 2014
Last updated
Aug 19, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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 R884978 MS Primary

Addresses

Primary practice location

2100 Highway 61 N
Vicksburg, MS 39183-8211

Mailing address

159 Madera LN
159 Madera Lane
Vicksburg, MS 39180-8082
Phone (601) 629-6111

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
I20180918003601 MS Practitioner - Nurse Practitioner 5597016345 Reassigns benefits to 1 organization

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
Vicksburg Healthcare LLCGroup PAC ID 4688575129, 10 clinicians

Practice addresses (Care Compare)

2100 Hwy 61 N
Vicksburg, MS 39183-8211
Phone (601) 883-5001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R884978MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vicksburg Healthcare LLC CurrentSince Apr 16, 2024 Accepting new patients
Vicksburg Hma Physician Management LLC Current Accepting new patients
Medical Associates of Vicksburg PLLC CurrentSince Dec 14, 2022 Accepting new patients
Vicksburg Healthcare LLC CurrentSince Apr 16, 2024 Accepting new patients

Locations

2080 S Frontage Rd
Ste 100
Vicksburg, MS 39180
Phone (601) 262-1000

2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001

Organizations & group practices 4

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": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1871992818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 MADERA LN",
            "address_2": "159 MADERA LANE",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391808082",
            "telephone_number": "601-629-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838211",
            "telephone_number": "601-883-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "NATASHA",
        "middle_name": "YVONNEAVION",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R884978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

Verify at the official NPI Registry.