Angelique Moneka Hunter
Individual provider Active NPI Gerontology Nurse Practitioner · Greenwood, MS
NPI 1083390967 · NPPES record last updated Oct 5, 2023
Key facts
- NPI
- 1083390967
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- 906094 (MS)
- Practice address
- 708 West Claiborne Ave
Greenwood, MS 38930 - Phone
- (662) 897-4245
- NPI assigned
- Jun 26, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Minor Med Care, LLC
MDB Behavioral Health Services LLC
Practice addresses (Care Compare)
120 W Main St
Raymond, MS 39154-1223
Phone (601) 857-2341
1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598
Hospital & facility affiliations
- Greenwood Leflore Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231218001608 | MS | Practitioner - Nurse Practitioner | 7214386168 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 912643 | MS | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minor Med Care, LLC | Current |
Accepting new patients | |
| Minor Med Care, LLC | Current |
Accepting new patients | |
| Community Care Health Network LLC | Current |
Accepting new patients | |
| Truhealth, LLC | Current |
Accepting new patients | |
| Uppal Medical Center LLC | Current |
Accepting new patients | |
| MDB Behavioral Health Services LLC | Current |
Accepting new patients |
Locations
9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883
200 N Martin Luther King Dr
Cleveland, MS 38732
Phone (662) 843-5347
1727 E Union St
Greenville, MS 38703
Phone (662) 332-0373
232 Market St
Jackson, MS 39232
Phone (588) 498-6767
215 Katherine Dr
#A
Jackson, MS 39232
2860 McDowell Road Ext
Jackson, MS 39204
Phone (601) 372-1117
925 Calhoun Ave
Yazoo City, MS 39194
Phone (662) 746-6651
1971 Tennessee Ave N
Parsons, TN 38363
Phone (731) 614-1424
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 912643 | MS | |
| Gerontology Nurse Practitioner | 363LG0600X | 906094 | MS | Yes |
Addresses
Primary practice location
708 West Claiborne Ave
Greenwood, MS 38930
Mailing address
708 West Claiborne Ave
Greenwood, MS 38930
Phone (662) 897-4245
Other providers in Greenwood, MS
- Cabrecia Howard
- Latonya Howard
- Margaret Howerton
- Timothy W Huddleston
- Vivian Elizabeth 'Lisa' Huddleston
- Indywood Glen, LLC
- Dorothy Ivory
- J and J Primary Healthcare Services
- Angela Renee Jackson
- Jazzme Jackson
All providers in Greenwood, MS · Gerontology Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.