Individual provider Active NPI

Mary Elizabeth Spreafico, FNP

  • Family Nurse Practitioner
  • Sebstopol, MS
National Provider Identifier
1104036177
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R865728 Issued in MS
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

Updated by the provider on Jun 8, 2026

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 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

IdentifierTypeStateIssuer
06427823MedicaidMS

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
I20070918000038 MS Practitioner - Nurse Practitioner 8729172010 Reassigns benefits to 3 organizations

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
East Central Mississippi Health Care IncGroup PAC ID 0941103717, 16 clinicians

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

LicenseStateTypeSpecialty
R865728MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neshoba County General Hospital Current Accepting new patients
Neshoba County General Hospital CurrentSince Jan 1, 2025 Accepting new patients
East Central Mississippi Health Care Inc CurrentSince Jul 28, 2025 Accepting new patients
East Central Mississippi Health Care, Inc Current Accepting new patients
East Central Mississippi Health Care, Inc. CurrentSince Jul 28, 2025 Accepting new patients
Neshoba County General Hospital CurrentSince Jan 1, 2025 Accepting new patients
Pain Management Ctr Meridian CurrentSince Jan 22, 2024 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

  • FHIR API: https://api.platform.athenahealth.com/17349/brand/1/csg/1/fhir/r4
  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.