NPIMap

Individual provider Active NPI

Lance P Klein, NP

  • Acute Care Nurse Practitioner
  • Flowood, MS
National Provider Identifier
1881635225
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R831651 Issued in MS
Practice address
2470 Flowood Dr
Flowood, MS 39232-9019
Phone
(601) 936-0400
Fax
(601) 983-2845
NPI assigned
Jun 9, 2006
Last updated
Mar 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R831651 MS
Acute Care Nurse Practitioner 363LA2100X R831651 MS Primary

Addresses

Primary practice location

2470 Flowood Dr
Flowood, MS 39232-9019

Mailing address

PO Box 3488
Tupelo, MS 38803-3488
Phone (877) 554-4257

Other identifiers 1

IdentifierTypeStateIssuer
06352389MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050411000664 MS Practitioner - Nurse Practitioner 0749227841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newsouth Neurospine, LLCGroup PAC ID 2163591579, 22 clinicians

Practice addresses (Care Compare)

2470 Flowood Dr
Flowood, MS 39232-9019
Phone (601) 983-2859

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R831651MSMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Newsouth Neurospine, LLC. CurrentSince Apr 6, 2009 Accepting new patients
Newsouth Neurospine, LLC Current Accepting new patients
E Thomas Cullom III MD PLLC PastSince Aug 1, 2008 Accepting new patients
River Oaks Management Company LLC Nurse Practitioner Past Accepting new patients
Sterling Emergency Services of Mississippi, Inc Nurse Practitioner Past Accepting new patients

Locations

2470 Flowood Dr
Jackson, MS 39232
Phone (601) 291-1407

Organizations & group practices 5

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 6

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1881635225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3488",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388033488",
            "telephone_number": "877-554-4257",
            "fax_number": "601-983-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 FLOWOOD DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329019",
            "telephone_number": "601-936-0400",
            "fax_number": "601-983-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "LANCE",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R831651",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "R831651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06352389",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

Verify at the official NPI Registry.