Brandon Heath Petty

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R903557 Issued in MS

Practice address

499 Gloster Creek VLG Ste A2
Tupelo, MS 38801-4749

Phone

(662) 620-6800

Fax

(662) 620-6950

NPI assigned

Nov 6, 2019

Last updated

Nov 6, 2019By the provider in NPPES

Sex

Male

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Mississippi Clinics LLCGroup PAC ID 3870773914, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brandonpetty@nmhs.medalliesdirect.net

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

• North Mississippi Clinics LLC

  dba Cardiology Associates of North MS Clinic

  • Cardiovascular Disease Physician
  • Tupelo, MS
  • NPI 1326749540
  Medicare reassignment Care Compare group NPD
• Cardiology Associates of North Ms PA

  • Cardiovascular Disease Physician
  • Tupelo, MS
  • NPI 1902971492
  Medicare reassignment NPD
• North Mississippi Clinics LLC

  dba Cardiology Associates of North MS Clinic

  • Cardiovascular Disease Physician
  • Columbus, MS
  • NPI 1487355608
  NPD
• North Mississippi Clinics LLC

  dba Cardiology Associates of North MS Clinic

  • Cardiovascular Disease Physician
  • Corinth, MS
  • NPI 1720789944
  NPD
• North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1376969683
  NPD
• Webster Health Services, Inc.

  dba Webster Health Services Ambulance

  • Land Ambulance
  • Eupora, MS
  • NPI 1487759734
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Mississippi Medical Center, Inc.

  dba North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1598875460
  Care Compare affiliation

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1073157715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG STE A2",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014749",
            "telephone_number": "662-620-6800",
            "fax_number": "662-620-6950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG STE A2",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014749",
            "telephone_number": "662-620-6800",
            "fax_number": "662-620-6950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "BRANDON",
        "middle_name": "HEATH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-06",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R903557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenka Petersen, M.D.
• Daymon D Peterson, MD
• Jana Louann Peterson, NP
• Emma Pettey
• Michael H Pettis, LCSW
• Shekiva Petty
• Pharmacy Innovations LLC (Tupelo Drugs)
• Pharmacy Management Group (Total Care Pharmacy of Tupelo)
• Clyde Bennett Phillips, MD
• John O Phillips, MD

• Nurse Practitioner in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.