Individual provider Active NPI

Sharon Marie Brady, NP

  • Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1912299496
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R587974 Issued in MS
Practice address
2024 15TH St
FL 2
Meridian, MS 39301-4130
Phone
(601) 553-2000
Fax
(601) 483-9471
NPI assigned
May 3, 2011
Last updated
Apr 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R587974 MS Primary

Addresses

Primary practice location

2024 15TH St
FL 2
Meridian, MS 39301-4130

Mailing address

2024 15TH St
FL 2
Meridian, MS 39301-4130
Phone (601) 553-2000

Other identifiers 1

IdentifierTypeStateIssuer
04036034MedicaidMS

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
I20120717000567 MS Practitioner - Nurse Practitioner 8325204415 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Medical Associates, PA Nurse Practitioner CurrentSince Mar 28, 2016 Accepting new patients

Locations

2024 15th St
Fl 2
Meridian, MS 39301
Phone (601) 553-2000

2124 14th St
Meridian, MS 39301
Phone (601) 483-8811

1056 Holland Ave
Philadelphia, MS 39350
Phone (601) 656-1465

Organizations & group practices 1

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": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1912299496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 15TH ST",
            "address_2": "FL 2",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014130",
            "telephone_number": "601-553-2000",
            "fax_number": "601-483-9471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 15TH ST",
            "address_2": "FL 2",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014130",
            "telephone_number": "601-553-2000",
            "fax_number": "601-483-9471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "SHARON",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-03",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R587974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04036034",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.