DIVINITY HEALTHCARE INC
NPI 1396567301
Nurse Practitioner - Family in West Point, MS
About Divinity Healthcare Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DIVINITY HEALTHCARE INC (NPI 1396567301) is a healthcare organization registered as a family in West Point, Mississippi and active in the NPI registry since October 2024. The organization holds a CLIA Waiver certificate valid through July 16, 2027 and lists Trinity Sharda Johnson, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Divinity Healthcare Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Divinity Healthcare Inc, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 25D2327159
Divinity Healthcare Inc · West Point, MSFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Divinity Healthcare Inc's NPI number?
The NPI number for Divinity Healthcare Inc is 1396567301. It was assigned to this organization in the NPPES registry on October 30, 2024.
Where is Divinity Healthcare Inc located?
Divinity Healthcare Inc is located at 99 Winchester Dr Unit K, West Point, MS 39773. The listed phone number is (662) 848-3656.
What is Divinity Healthcare Inc's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Divinity Healthcare Inc enrolled in Medicare?
Yes. Divinity Healthcare Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Divinity Healthcare Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Divinity Healthcare Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Divinity Healthcare Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 25D2327159) is associated with this NPI, valid through July 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Divinity Healthcare Inc accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Divinity Healthcare Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Divinity Healthcare Inc was last updated on April 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Divinity Healthcare Inc · NPI 1396567301
Family organization in West Point, Mississippi. Organization record, active in the CMS NPPES registry since October 30, 2024.
## Identity
- **NPI:** 1396567301 (Entity type: Organization)
- **Enumerated:** October 30, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Also known as:** DIVINITY HEALTHCARE INC (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Trinity Johnson, OWNER
## Practice location
- **Address:** 99 WINCHESTER DR UNIT K, West Point, MS 39773-2083
- **Phone:** (662) 848-3656
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 7, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1396567301) · Data from the CMS NPPES public registry.