Ivyraine Women'S Clinic
NPI 1962166264 · Women's Health Nurse Practitioner · Southaven, MS
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ivyraine Women'S Clinic is a Women's Health Nurse Practitioner organization in Southaven, MS (NPI 1962166264).
Provider details
- NPI number
- 1962166264
- Entity type
- Organization
- Primary specialty
- Women's Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Jennifer Fredrickson, NP(662) 856-8440
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
Mailing address
Registry dates
- Enumerated
- 2021-10-24
- Last updated
- 2021-12-29
- Certified
- 2021-12-29
Frequently asked questions
- What is Ivyraine Women'S Clinic's NPI number?
- Ivyraine Women'S Clinic's National Provider Identifier (NPI) is 1962166264, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ivyraine Women'S Clinic?
- Ivyraine Women'S Clinic is classified in the NPPES registry as Women's Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Ivyraine Women'S Clinic located?
- Ivyraine Women'S Clinic's practice location on file with NPPES is 3964 Goodman Rd E Ste 131, Southaven, MS 38672-8762.
- What is Ivyraine Women'S Clinic's phone number?
- The practice phone number listed in the NPPES registry for Ivyraine Women'S Clinic is (662) 856-8440.
- Does Ivyraine Women'S Clinic accept Medicare?
- Ivyraine Women'S Clinic is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Ivyraine Women'S Clinic?
- The authorized official listed on Ivyraine Women'S Clinic's NPPES record is Jennifer Fredrickson, NP. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ivyraine Women'S Clinic's NPI active?
- Yes — Ivyraine Women'S Clinic's NPI (1962166264) is active in the NPPES registry as of the last update on 2021-12-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.