Staci Lowrey, FNP
Individual provider Active NPI Family Nurse Practitioner · Walnut, MS
NPI 1124796669 · NPPES record last updated Apr 12, 2024
Key facts
- NPI
- 1124796669
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 906289 (MS)
- Practice address
- 531 Main St
Walnut, MS 38683-9349 - Phone
- (662) 223-4011
- NPI assigned
- Aug 31, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 13
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Mississippi Primary Health Care Inc
Practice addresses (Care Compare)
71 Mitchell Ave
Walnut Imaging Center
Walnut, MS 38683
Phone (662) 223-4011
Hospital & facility affiliations
- Centerwell Home Health
- Baptist Memorial Hospital Union County
- Magnolia Regional Health Center
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 |
|---|---|---|---|---|
| I20240207003086 | MS | Practitioner - Nurse Practitioner | 9436592318 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 906289 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Mississippi Primary Health Care, Inc. | Current |
Accepting new patients | |
| North Mississippi Primary Health Care, Inc. | Current |
Accepting new patients | |
| North Mississippi Primary Health Care, Inc. | Current | Accepting new patients | |
| North Mississippi Primary Health Care, Inc. | Past | Accepting new patients |
Locations
208 N 1st St
Booneville, MS 38829
Phone (601) 728-2165
1415 S Harper Rd
Corinth, MS 38834
Phone 6622248951299
749 S Line St
Ripley, MS 38663
Phone (662) 837-0000
531 Main St
Walnut, MS 38683
Phone (662) 223-4011
Interoperability endpoints
- staci.lowrey.1@28179.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 906289 | MS | Yes |
Addresses
Primary practice location
531 Main St
Walnut, MS 38683-9349
Mailing address
PO Box 154
Myrtle, MS 38650-0154
Phone (662) 316-6458
Other providers in Walnut, MS
- Duncans Pharmacy Inc
- Ashley Monique Gaffney
- Markita Sherise Gary
- Matthew Gray
- James D Jackson Jr.
- Vivian Martindale
- North Mississippi Primary Health Care, Inc.
- North Mississippi Primary Health Care, Inc.
- North Mississippi Primary Health Care, Inc.
- Jessica Gail Prather
All providers in Walnut, MS · Family 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 Apr 12, 2024. 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.