Andrew Blake McCaulley, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

904105 Issued in MS

Practice address

1507 W Quitman St
Iuka, MS 38852-1133

Phone

(662) 423-1000

NPI assigned

Aug 27, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Truhealth LLCGroup PAC ID 2163653478, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital Booneville Hospital, Booneville, MS, CCN 250044

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 and National Provider Directory roles.

• Truhealth, LLC

  • Nurse Practitioner
  • Parsons, TN
  • NPI 1063843951

  MS

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Memorial Hospital-Booneville, Inc.

  • General Acute Care Hospital
  • Booneville, MS
  • NPI 1396709978
  Care Compare affiliation

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

{
    "created_epoch": "1598486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1114530342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 W QUITMAN ST",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "38852",
            "telephone_number": "662-423-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 W QUITMAN ST",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521133",
            "telephone_number": "662-423-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAULLEY",
        "first_name": "ANDREW",
        "middle_name": "BLAKE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-27",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stevie Nicole Ligon, BS
• Natalie Mallard
• April W Mallette
• Angie Manahan
• Theresa M Massey, FNP
• Amy C McDeavitt
• Randy L McDuffy
• Brenton McKay, FNP
• Molly McLain, MSN, APRN, PMHNP-BC
• Brianna Meador

• Family Nurse Practitioner in Iuka, MS
• Providers in Iuka, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; 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.

Verify at the official NPI Registry.