MRS. LISA DELORIS SLADE FNP-BC NPI 1013080027

NPI Information

  • NPI: 1013080027
  • Provider Name: MRS. LISA DELORIS SLADE, FNP-BC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 605 STADIUM DR
    HATTIESBURG, MS
    ZIP 39401
  • Phone: (601) 450-0310

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NPI Details

MRS. Lisa Deloris Slade, FNP-BC is a family nurse practitioner in Hattiesburg, MS with 19 years of experience. MRS. Lisa Deloris Slade, FNP-BC NPI is 1013080027. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

605 STADIUM DR
HATTIESBURG, MS
ZIP 39401-156
Phone: (601) 450-0310
Fax: (601) 450-0321

The NPI 1013080027 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Dialysis services, 2-3 physician visits per month (20 years or older) (HCPCS:90961)

The enumeration date for this NPI number is 11/16/2006 and was last updated on 1/9/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyR772518MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11719640P01OTHERMISSISSIPPICIGNA
211838342OTHERMISSISSIPPICAQH ID #
39989130OTHERMISSISSIPPIAETNA
42888996OTHERMISSISSIPPIUNITED HEALTH CARE
51043492770OTHERMISSISSIPPIFIRST CHOICE OF MISSISSIPPI
608700008MEDICAIDMISSISSIPPI
7512I500155MEDICARE PINMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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