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  7. NPI Record 1437509312

MANERVIA LEE
Complete NPI Record 1437509312
Licensed Practical Nurse in Jackson, MS

NPI Status: Active since June 21, 2016

Contact Information

1058 RIDGEWOOD PL STE G
JACKSON, MS
ZIP 39211
Phone: (601) 809-9222

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Enumeration Date
  18. Last Update Date
  19. Provider Gender Code
  20. Healthcare Provider Taxonomy Code 1
  21. Provider License Number 1
  22. Provider License Number State Code 1
  23. Healthcare Provider Primary Taxonomy Switch 1
  24. Healthcare Provider Taxonomy Code 2
  25. Provider License Number 2
  26. Provider License Number State Code 2
  27. Healthcare Provider Primary Taxonomy Switch 2
  28. Healthcare Provider Taxonomy Code 3
  29. Provider License Number 3
  30. Provider License Number State Code 3
  31. Healthcare Provider Primary Taxonomy Switch 3
  32. Healthcare Provider Taxonomy Code 4
  33. Provider License Number 4
  34. Provider License Number State Code 4
  35. Healthcare Provider Primary Taxonomy Switch 4
  36. Healthcare Provider Taxonomy Code 5
  37. Healthcare Provider Primary Taxonomy Switch 5
  38. Healthcare Provider Taxonomy Code 6
  39. Healthcare Provider Primary Taxonomy Switch 6
  40. Healthcare Provider Taxonomy Code 7
  41. Healthcare Provider Primary Taxonomy Switch 7
  42. Healthcare Provider Taxonomy Code 8
  43. Provider License Number 8
  44. Provider License Number State Code 8
  45. Healthcare Provider Primary Taxonomy Switch 8
  46. Healthcare Provider Taxonomy Code 9
  47. Healthcare Provider Primary Taxonomy Switch 9
  48. Healthcare Provider Taxonomy Code 10
  49. Provider License Number 10
  50. Provider License Number State Code 10
  51. Healthcare Provider Primary Taxonomy Switch 10
  52. Healthcare Provider Taxonomy Code 11
  53. Healthcare Provider Primary Taxonomy Switch 11
  54. Healthcare Provider Taxonomy Code 12
  55. Healthcare Provider Primary Taxonomy Switch 12
  56. Healthcare Provider Taxonomy Code 13
  57. Healthcare Provider Primary Taxonomy Switch 13
  58. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1437509312. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1437509312
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: MANERVIA
The first name of the provider, if the provider is an individual.
Provider First Line Business Mailing Address: 1058 RIDGEWOOD PL STE G
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: JACKSON
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MS
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 392112002
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 6018099222
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 1058 RIDGEWOOD PL STE G
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: JACKSON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: MS
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 392112002
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 6018099222
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/21/2016
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 1/19/2017
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 163WA2000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 865836
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: MS
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 163WC0400X
Provider License Number 2: 865836
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 2: MS
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 2: N
Healthcare Provider Taxonomy Code 3: 163WH0200X
Provider License Number 3: 865836
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 3: MS
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 3: N
Healthcare Provider Taxonomy Code 4: 164W00000X
Provider License Number 4: 326285
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 4: MS
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 4: Y
Healthcare Provider Taxonomy Code 5: 174400000X
Healthcare Provider Primary Taxonomy Switch 5: N
Healthcare Provider Taxonomy Code 6: 372600000X
Healthcare Provider Primary Taxonomy Switch 6: N
Healthcare Provider Taxonomy Code 7: 373H00000X
Healthcare Provider Primary Taxonomy Switch 7: N
Healthcare Provider Taxonomy Code 8: 374U00000X
Provider License Number 8: 36693
Provider License Number State Code 8: MS
Healthcare Provider Primary Taxonomy Switch 8: N
Healthcare Provider Taxonomy Code 9: 376J00000X
Healthcare Provider Primary Taxonomy Switch 9: N
Healthcare Provider Taxonomy Code 10: 376K00000X
Provider License Number 10: 36693
Provider License Number State Code 10: MS
Healthcare Provider Primary Taxonomy Switch 10: N
Healthcare Provider Taxonomy Code 11: 172V00000X
Healthcare Provider Primary Taxonomy Switch 11: N
Healthcare Provider Taxonomy Code 12: 171M00000X
Healthcare Provider Primary Taxonomy Switch 12: N
Healthcare Provider Taxonomy Code 13: 174H00000X
Healthcare Provider Primary Taxonomy Switch 13: N
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No