Amanda Chappell, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

904670 Issued in MS

Practice address

201 Highway 51 N Ste a
Brookhaven, MS 39601-2653

Phone

(601) 515-4949

NPI assigned

Jun 7, 2021

Last updated

Sep 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Care Health Network LLC

  dba Matrix Medical Network

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  MS

  Medicare reassignment NPD

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1083281174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 NOBLE DR",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013628",
            "telephone_number": "601-316-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HIGHWAY 51 N STE A",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012653",
            "telephone_number": "601-515-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPPELL",
        "first_name": "AMANDA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MS",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "904670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Graham Carter, FNP-C
• Amy Katheryn Case, FNP, ADM
• Kimberly Case
• Meghan Lynn Case, MD
• Ryan Corey Case, MD
• Robert Dean Chappell Jr., FNP-C
• Paige V Chisolm, NP
• Chloe's Caring Hands Healthcare LLC
• Jeffrey G Clark, M.D.
• Candice Nicole Cliburn, NURSE PRACTITIONER

• Primary Care Nurse Practitioner in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Primary Care Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.