Individual provider Active NPI

Madison Windham, FNP-C

  • Family Nurse Practitioner
  • Newton, MS
National Provider Identifier
1164170734
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
905153 Issued in MS
Practice address
9427 Eastside Drive Ext Ste a
Newton, MS 39345-8063
Phone
(601) 683-0330
NPI assigned
Mar 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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 905153 MS Primary

Addresses

Primary practice location

9427 Eastside Drive Ext Ste a
Newton, MS 39345-8063

Mailing address

9427 Eastside Drive Ext Ste a
Newton, MS 39345-8063
Phone (601) 683-0330

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
I20220427001081 MS Practitioner - Nurse Practitioner 1557758216 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9427 Eastside Dr Ext
Suite a
Newton, MS 39345-8063
Phone (601) 681-0330

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
905153MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Healthcare Management, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Independent Healthcare Management, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Independent Healthcare Management, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Independent Healthcare Management, Inc. PastSince Jun 21, 2022 Accepting new patients

Locations

330 N Broad St
#S
Forest, MS 39074
Phone (601) 469-4151

330 N Broad St
Forest, MS 39074
Phone (601) 469-4151

360 Simpson Highway 149
Ste 140
Magee, MS 39111

376 Simpson Highway 149
Ste 300
Magee, MS 39111
Phone (601) 721-8985

110 Pioneer Way
Magee, MS 39111

347 S Fourth St
Morton, MS 39117
Phone (601) 732-1524

9427 Eastside Drive Ext
#A
Newton, MS 39345
Phone (601) 681-0330

Interoperability endpoints

  • Direct secure messaging: madison.windham@phspch.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1164170734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9427 EASTSIDE DRIVE EXT STE A",
            "city": "NEWTON",
            "state": "MS",
            "postal_code": "393458063",
            "telephone_number": "601-683-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9427 EASTSIDE DRIVE EXT STE A",
            "city": "NEWTON",
            "state": "MS",
            "postal_code": "393458063",
            "telephone_number": "601-683-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDHAM",
        "first_name": "MADISON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MS

Sources for this page

Verify at the official NPI Registry.