Active NPI
Mary Elizabeth Spreafico, FNP
- Family Nurse Practitioner
- Sebstopol, MS
National Provider Identifier
1104036177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R865728
- Practice address
- 1488 Hwy 487 East
Sebstopol, MS 39359-0150 - Phone
- (601) 625-7403
- Fax
- (844) 816-5721
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R865728 | MS | Primary |
Addresses
Primary practice location
1488 Hwy 487 East
Sebstopol, MS 39359-0150
Mailing address
PO Box 150
Sebastopol, MS 39359-0150
Phone (601) 625-7403
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06427823 | Medicaid | MS |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1488 Hwy 487
Sebastopal Clinic
Sebastopol, MS 39359-0150
Phone (601) 625-7403
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R865728 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neshoba County General Hospital | Current | Accepting new patients | |
| Neshoba County General Hospital | Current | Accepting new patients | |
| East Central Mississippi Health Care Inc | Current | Accepting new patients | |
| East Central Mississippi Health Care, Inc | Current | Accepting new patients | |
| East Central Mississippi Health Care, Inc. | Current | Accepting new patients | |
| Neshoba County General Hospital | Current | Accepting new patients | |
| Pain Management Ctr Meridian | Current | Accepting new patients |
Locations
7956 Vaughn Rd
Ste 165
Montgomery, AL 36116
1102 Constitution Ave
Meridian, MS 39301
Phone (601) 693-2511
1001 Holland Ave
Philadelphia, MS 39350
Phone (601) 663-1200
Interoperability endpoints
- https://api.platform.athenahealth.com/17349/brand/1/csg/1/fhir/r4
- mary.spreafico.1@17349.direct.athenahealth.com
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Walnut Grove, MS
- NPI 1255387619
-
- Certified Registered Nurse Anesthetist
- Philadelphia, MS
- NPI 1114057247
-
- Pain Medicine (Anesthesiology) Physician
- Meridian, MS
- NPI 1225096613
-
- Federally Qualified Health Center (FQHC)
- Sebastopol, MS
- NPI 1699721209
-
- Federally Qualified Health Center (FQHC)
- Newton, MS
- NPI 1184090482
-
- Emergency Medical Services (Emergency Medicine) Physician
- Philadelphia, MS
- NPI 1003946138
-
- Critical Access Hospital
- Philadelphia, MS
- NPI 1083659734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780876800000",
"number": "1104036177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 150",
"city": "SEBASTOPOL",
"state": "MS",
"postal_code": "393590150",
"telephone_number": "601-625-7403",
"fax_number": "844-816-5721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1488 HWY 487 EAST",
"city": "SEBSTOPOL",
"state": "MS",
"postal_code": "393590150",
"telephone_number": "601-625-7403",
"fax_number": "844-816-5721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPREAFICO",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2026-06-08",
"certification_date": "2026-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R865728",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06427823",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.