Individual provider Active NPI

Michele Bryant Mahaffey, FNP

  • Family Nurse Practitioner
  • Prentiss, MS
National Provider Identifier
1194745315
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R667552 Issued in MS
Practice address
1014 Rose St
Suite a
Prentiss, MS 39474-5271
Phone
(601) 792-2200
Fax
(601) 792-2345
NPI assigned
Jul 20, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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 R667552 MS Primary

Addresses

Primary practice location

1014 Rose St
Suite a
Prentiss, MS 39474-5271

Mailing address

PO Box 667
1014 Rose Street Suite a
Prentiss, MS 39474-0667
Phone (601) 792-2200

Other practice location 1

2650 Beach Blvd Ste 40
Biloxi, MS 39531-4517
Phone (228) 200-8451

Other identifiers 2

IdentifierTypeStateIssuer
05851817MedicaidMS
12117492OtherMSCAQH

Other names 1

  • Michele Bryant Coward Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michele.mahaffey.1@29601.direct.athenahealth.com

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
I20060815000164 MS Practitioner - Nurse Practitioner 9032112933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forrest County General HospitalGroup PAC ID 1052397767, 107 clinicians

Practice addresses (Care Compare)

1014 Rose St
Suite a
Prentiss, MS 39474-5271
Phone (601) 792-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R667552MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Nov 29, 2011 Accepting new patients
Forrest County General Hospital Current Accepting new patients
Forrest County General Hospital CurrentSince Nov 29, 2011 Accepting new patients

Locations

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

1014 Rose St
Ste A
Prentiss, MS 39474
Phone (601) 792-2200

1102 Rose St
Prentiss, MS 39474
Phone (601) 792-2947

Organizations & group practices 3

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 7

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1194745315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 667",
            "address_2": "1014 ROSE STREET SUITE A",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "394740667",
            "telephone_number": "601-792-2200",
            "fax_number": "601-792-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 ROSE ST",
            "address_2": "SUITE A",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "394745271",
            "telephone_number": "601-792-2200",
            "fax_number": "601-792-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Beach Blvd Ste 40",
            "address_purpose": "LOCATION",
            "city": "Biloxi",
            "state": "MS",
            "postal_code": "395314517",
            "country_code": "US",
            "telephone_number": "228-200-8451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHAFFEY",
        "first_name": "MICHELE",
        "middle_name": "BRYANT",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R667552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05851817",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12117492",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michele.mahaffey.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "2650 Beach Blvd Ste 40",
            "city": "Biloxi",
            "state": "MS",
            "country_code": "US",
            "postal_code": "395314517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "COWARD",
            "middle_name": "BRYANT",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Prentiss, MS

Sources for this page

Verify at the official NPI Registry.