OrganizationActive
Advanced Diabetes Management Center LLC
NPI 1528465424 · Family Nurse Practitioner · Tupelo, MS
Provider details
- NPI number
- 1528465424
- Entity type
- Organization
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Nativel Collins, Np/Owner(662) 842-7840
- License
- R873068 (MS)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
449 Gloster Creek
Suite H-9
Tupelo, MS 38801-0000
Phone: (662) 842-7840
Fax: (662) 842-7873
Street-level locationGet directions
Mailing address
449 Gloster Creek
Tupelo, MS 38801-0000
Registry dates
- Enumerated
- 2014-11-21
- Last updated
- 2015-01-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.