Individual provider Active NPI

Elaina Ponder, FNP-C

  • Family Nurse Practitioner
  • Amory, MS
National Provider Identifier
1235783127
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902890 Issued in MS
Practice address
1506 U.S. 278 Suite a
Amory, MS 38821
Phone
(662) 305-9149
NPI assigned
Jul 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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 902890 MS Primary

Addresses

Primary practice location

1506 U.S. 278 Suite a
Amory, MS 38821

Mailing address

50018 Sims LN
Amory, MS 38821-8859
Phone (662) 315-5612

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
I20200825003861 MS Practitioner - Nurse Practitioner 2062839814 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
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

300 Front St S
Suite 6
Amory, MS 38821-4202
Phone (662) 315-5612

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boa Vida Hospital of Aberdeen, Ms, LLC CurrentSince Dec 1, 2022 Accepting new patients
Magnolia Mobile Home Care LLC CurrentSince Mar 7, 2023 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms LLC CurrentSince Dec 1, 2022 Accepting new patients

Locations

400 S Chestnut St
Aberdeen, MS 39730
Phone (662) 369-2455

1506 Highway 278 E
Ste A
Amory, MS 38821
Phone (662) 597-1905

300 Front St S
Ste 6
Amory, MS 38821
Phone (662) 315-5612

Interoperability endpoints

  • Direct secure messaging: elaina.ponder.1@29046.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1235783127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50018 SIMS LN",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388218859",
            "telephone_number": "662-315-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 U.S. 278 SUITE A",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "38821",
            "telephone_number": "662-305-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDER",
        "first_name": "ELAINA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amory, MS

Sources for this page

Verify at the official NPI Registry.