Individual provider Active NPI

Mylie Kate Beane, FNP-C

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1194497032
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904900 Issued in MS
Practice address
830 S Gloster St
Tupelo, MS 38801-4934
Phone
(662) 377-3000
NPI assigned
Sep 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 906379 MS
Family Nurse Practitioner 363LF0000X 904900 MS Primary

Addresses

Primary practice location

830 S Gloster St
Tupelo, MS 38801-4934

Mailing address

830 S Gloster St
Tupelo, MS 38801-4934
Phone (662) 377-3000

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
I20220125001335 MS Practitioner - Nurse Practitioner 3274925243 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
North Mississippi Medical Center, Inc.Group PAC ID 9931010600, 361 clinicians

Practice addresses (Care Compare)

499 Gloster Creek VLG
Suite S 3
Tupelo, MS 38801-4600
Phone (662) 377-8025

Hospital & facility affiliations

  • North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
906379MSMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Clinics Inc CurrentSince Jan 2, 2022 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Feb 24, 2022 Accepting new patients
North Mississippi Medical Clinics Inc Family Current Accepting new patients
North Mississippi Medical Center, Inc CurrentSince Feb 24, 2022 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
Amory Surgery Clinic, PLLC Past Accepting new patients

Locations

2161 S Lamar Blvd
Oxford, MS 38655
Phone (662) 234-1791

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

499 Gloster Creek Vlg
Ste S3
Tupelo, MS 38801
Phone (662) 377-8025

Interoperability endpoints

  • Direct secure messaging: myliebeane@nmhs.medalliesdirect.net

Organizations & group practices 15

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.

View all 15

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": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1194497032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-377-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-377-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEANE",
        "first_name": "MYLIE",
        "middle_name": "KATE",
        "name_prefix": "Miss",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "906379",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.