Amanda Stauble, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903113 Issued in MS

Practice address

1225 N State St
Jackson, MS 39202

Phone

(601) 201-7188

NPI assigned

Jul 24, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

78.38 of 100Reported as group

Quality

54.22

Promoting interoperability

100

Improvement activities

40

Cost

73.72

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medical Foundation of Central Mississippi, Inc.

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1992774814

  MS

  Medicare reassignment NPD
• Mississippi Baptist Medical Center, Inc.

  • Neurology Physician
  • Jackson, MS
  • NPI 1467589556

  MS

  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527

  MS

  Medicare reassignment NPD
• Mississippi Hma Hospitalists, LLC

  • Hospitalist Physician
  • Jackson, MS
  • NPI 1154608883

  MS

  Medicare reassignment
• Vicksburg Clinic LLC

  • Family Medicine Physician
  • Vicksburg, MS
  • NPI 1790711158

  MS

  Medicare reassignment
• Vicksburg Healthcare LLC

  • Anesthesiology Physician
  • Vicksburg, MS
  • NPI 1629084058

  MS

  Medicare reassignment
• Medical Foundation of Central Ms

  • Family Medicine Physician
  • Brandon, MS
  • NPI 1114264264
  NPD
• Mississippi Baptist Medical Center, Inc

  • Hospitalist Physician
  • Jackson, MS
  • NPI 1962867093
  NPD
• Mississippi Baptist Medical Center, Inc.

  • Community/Retail Pharmacy
  • Jackson, MS
  • NPI 1255882890
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1063768331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WOODSTOCK DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805747",
            "telephone_number": "601-201-7188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39202",
            "telephone_number": "601-201-7188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Marshall St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392021663",
            "country_code": "US",
            "telephone_number": "601-969-6404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAUBLE",
        "first_name": "AMANDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Statewide Healthcare Services, Inc
• Statewide Healthcare Services, Inc
• Statewide Healthcare Services, Inc.
• Statewide Healthcare Services, LLC
• Benjamin Statham, DO
• Denisse Leticia Staufert Gutierrez, MD
• Michelle Steadman
• Josephine Cenzalli Steevens, PHARM.D.
• Amanda Kellie Stegall, ACNPC-AG
• Jacob Michael Steiniger

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.