Individual provider Active NPI

Molly Grubbs Mayhugh, FNP

  • Family Nurse Practitioner
  • Monticello, MS
National Provider Identifier
1093201980
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902712 Issued in MS
Practice address
314 Main St Ste D
Monticello, MS 39654-3702
Phone
(601) 587-4304
Fax
(601) 587-4515
NPI assigned
Jul 3, 2018
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 902712 MS Primary

Addresses

Primary practice location

314 Main St Ste D
Monticello, MS 39654-3702

Mailing address

PO Box 23666
Jackson, MS 39225-3666
Phone (601) 200-4749

Other identifiers 1

IdentifierTypeStateIssuer
01071599MedicaidMS

Other names 1

  • Mrs. Molly Mayhugh Former name

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
I20190806004188 MS Practitioner - Nurse Practitioner 7416284922

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
902712MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bonita C. Musial Family Medicine PastSince Aug 27, 2023 Accepting new patients
Caring Hands Children's Clinic, LLC PastSince Aug 27, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8246/brand/1/csg/1/fhir/r4
  • Direct secure messaging: molly.mayhugh.1@8246.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1093201980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23666",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253666",
            "telephone_number": "601-200-4749",
            "fax_number": "601-200-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 MAIN ST STE D",
            "city": "MONTICELLO",
            "state": "MS",
            "postal_code": "396543702",
            "telephone_number": "601-587-4304",
            "fax_number": "601-587-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYHUGH",
        "first_name": "MOLLY",
        "middle_name": "GRUBBS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01071599",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "MAYHUGH",
            "prefix": "MRS.",
            "credential": "MOLLY GRUBBS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monticello, MS

Sources for this page

Verify at the official NPI Registry.