Individual provider Active NPI

Adam Meyers, AGACNP, RNFA

  • Gerontology Nurse Practitioner
  • Petal, MS
National Provider Identifier
1083021240
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R876127 Issued in MS
Practice address
6 Briarwood Loop
Petal, MS 39465-1009
Phone
(601) 270-8284
NPI assigned
Jul 18, 2014
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R876127 MS Primary
Registered Nurse First Assistant 163WR0006X 876127 MS

Addresses

Primary practice location

6 Briarwood Loop
Petal, MS 39465-1009

Mailing address

6 Briarwood Loop
Petal, MS 39465-1009
Phone (601) 270-8284

Other identifiers 1

IdentifierTypeStateIssuer
00008822MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ameyers40387@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140806001249 MS Practitioner - Nurse Practitioner 6507083078 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Mississippi School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forrest County General HospitalGroup PAC ID 1052397767, 107 clinicians

Practice addresses (Care Compare)

6051 US Hwy 49 S
Hattiesburg, MS 39401-7200
Phone (601) 288-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R876127MSMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Jul 1, 2022 Accepting new patients
Forrest County General Hospital CurrentSince Jul 1, 2022 Accepting new patients
FGH Physician Billing CurrentSince Jun 30, 2022 Accepting new patients
Forrest County General Hospital Current Accepting new patients
Forrest General Hospital Past Accepting new patients
Forrest County General Hospital Past Accepting new patients

Locations

2807 Arlington Loop
Hattiesburg, MS 39401
Phone (601) 288-3446

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

7125 U S Highway 98
Hattiesburg, MS 39402
Phone (601) 288-3446

801 Goodyear Blvd
Picayune, MS 39466
Phone (601) 749-0688

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1083021240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BRIARWOOD LOOP",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394651009",
            "telephone_number": "601-270-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BRIARWOOD LOOP",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394651009",
            "telephone_number": "601-270-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "ADAM",
        "credential": "AGACNP, RNFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-18",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "R876127",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "MS",
            "license": "876127",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00008822",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ameyers40387@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "415 S 28th Ave",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394017246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Petal, MS

Sources for this page

Verify at the official NPI Registry.