Individual provider Active NPI

Carly Maranne Hazzard Andrews, NP

  • Nurse Practitioner
  • Cleveland, MS
National Provider Identifier
1194211094
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
902784 Issued in MS
Practice address
800 N Pearman Ave
Cleveland, MS 38732-3502
Phone
(888) 757-0838
Fax
(662) 579-3378
NPI assigned
Jul 3, 2018
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 902784 MS Primary

Addresses

Primary practice location

800 N Pearman Ave
Cleveland, MS 38732-3502

Mailing address

800 N Pearman Ave
Cleveland, MS 38732-3502
Phone (888) 757-0838

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
I20181024002775 MS Practitioner - Nurse Practitioner 4183977994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Greenville ClinicGroup PAC ID 4082694641, 8 clinicians

Practice addresses (Care Compare)

1502 S Colorado St
Greenville, MS 38703-7219
Phone (662) 332-9872

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Sunflower Medical Center CurrentSince May 22, 2019 Accepting new patients
North Sunflower Medical Center CurrentSince May 22, 2019 Accepting new patients
North Sunflower Medical Center Current Accepting new patients

Locations

840 N Oak Ave
Ruleville, MS 38771
Phone (601) 756-2711

Interoperability endpoints

  • Direct secure messaging: carlyhazzardandrews@tgcpa.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1194211094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N PEARMAN AVE",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387323502",
            "telephone_number": "888-757-0838",
            "fax_number": "662-579-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N PEARMAN AVE",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387323502",
            "telephone_number": "888-757-0838",
            "fax_number": "662-579-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZZARD ANDREWS",
        "first_name": "CARLY",
        "middle_name": "MARANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "902784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, MS

Sources for this page

Verify at the official NPI Registry.