Individual provider Active NPI

Staci Lowrey, FNP

  • Family Nurse Practitioner
  • Walnut, MS
National Provider Identifier
1124796669
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906289 Issued in MS
Practice address
531 Main St
Walnut, MS 38683-9349
Phone
(662) 223-4011
NPI assigned
Aug 31, 2021
Last updated
Apr 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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 906289 MS Primary

Addresses

Primary practice location

531 Main St
Walnut, MS 38683-9349

Mailing address

PO Box 154
Myrtle, MS 38650-0154
Phone (662) 316-6458

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
I20240207003086 MS Practitioner - Nurse Practitioner 9436592318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

71 Mitchell Ave
Walnut Imaging Center
Walnut, MS 38683
Phone (662) 223-4011

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Primary Health Care, Inc. CurrentSince Dec 21, 2023 Accepting new patients
North Mississippi Primary Health Care, Inc. Current Accepting new patients
North Mississippi Primary Health Care, Inc. CurrentSince Dec 21, 2023 Accepting new patients
North Mississippi Primary Health Care, Inc. Past 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

  • Direct secure messaging: staci.lowrey.1@28179.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1124796669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 154",
            "city": "MYRTLE",
            "state": "MS",
            "postal_code": "386500154",
            "telephone_number": "662-316-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 MAIN ST",
            "city": "WALNUT",
            "state": "MS",
            "postal_code": "386839349",
            "telephone_number": "662-223-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWREY",
        "first_name": "STACI",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut, MS

Sources for this page

Verify at the official NPI Registry.