Amanda Michelle Whitacre, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

905840 Issued in MS

Practice address

34 Millbranch Rd
Hattiesburg, MS 39402-1686

Phone

(601) 909-9394

NPI assigned

Oct 30, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Region 12 Commission on Mental Health & Retardation Pine Belt Men

  dba Pine Belt Mental Health Care Resources

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hattiesburg, MS
  • NPI 1982610572
  Medicare reassignment NPD
• Region XII Commission

  • General Practice Physician
  • Laurel, MS
  • NPI 1467767988
  NPD
• MDB Behavioral Health Services LLC

  dba Complete Care Rural Health Clinic

  • Rural Health Clinic/Center
  • Vicksburg, MS
  • NPI 1669835310
  NPD (past)
• MDB Care Management LLC

  • Primary Care Nurse Practitioner
  • Flowood, MS
  • NPI 1144925272
  NPD (past)

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1215309133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 PRINCE GEORGE RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394022453",
            "telephone_number": "601-315-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MILLBRANCH RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021686",
            "telephone_number": "601-909-9394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1509 16th St NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200361461",
            "country_code": "US",
            "telephone_number": "202-289-1510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 Katherine Dr",
            "address_purpose": "LOCATION",
            "city": "Flowood",
            "state": "MS",
            "postal_code": "392329588",
            "country_code": "US",
            "telephone_number": "601-665-4162",
            "fax_number": "855-830-3484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITACRE",
        "first_name": "AMANDA",
        "middle_name": "MICHELLE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "905840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Wheeler, M.D.
• Keshia Wheeler
• Lauren M Wheeler, MS LPC NCC
• Lynwood Clinton Wheeler, PHD
• Bre'Anna Whigham
• Robert Greer Whitacre, M.D.
• Jordan Whitaker
• Christina White, PHARM.D., R.PH.
• Clinton B White, M.D.
• Corey White

• Psychiatric/Mental Health Nurse Practitioner in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.