Mary Sue Watkins, CFNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R733881 Issued in MS

Practice address

1014 Rose St
Prentiss, MS 39474-5271

Phone

(601) 792-2071

Fax

(601) 792-8134

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

State licenses

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.

• Covington County Hospital

  • Rural Health Clinic/Center
  • Taylorsville, MS
  • NPI 1306460282
  Medicare reassignment NPD
• Covington County Hospital

  • Rural Health Clinic/Center
  • Mt. Olive, MS
  • NPI 1336447861
  Medicare reassignment NPD
• Covington County Hospital

  • Rural Health Clinic/Center
  • Collins, MS
  • NPI 1518260330
  Medicare reassignment NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559

  Nurse Practitioner

  Medicare reassignment NPD
• Covington County Hospital

  • Rural Health Clinic/Center
  • Collins, MS
  • NPI 1598769044
  Medicare reassignment
• Covington County Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Collins, MS
  • NPI 1780706994
  NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  NPD
• Green Tree Family Medical Clinic

  • Rural Health Clinic/Center
  • Mt. Olive, MS
  • NPI 1770741191
  NPD
• St Michael Urgent Care of Hattiesburg LLC

  • Urgent Care Clinic/Center
  • Hattiesburg, MS
  • NPI 1396015087
  NPD
• St Michaels Urgent Care of Hattiesburg

  • Family Nurse Practitioner
  • Hattiesburg, MS
  • NPI 1124459136
  NPD
• Hattiesburg Clinic, PA

  • Family Medicine Physician
  • Lumberton, MS
  • NPI 1346780681
  NPD (past)
• State of Mississippi - University of Mississippi Medical Center

  • Critical Access Hospital
  • Lexington, MS
  • NPI 1386630705
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1245323914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-796-7030",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 ROSE ST",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "394745271",
            "telephone_number": "601-792-2071",
            "fax_number": "601-792-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "MARY",
        "middle_name": "SUE",
        "credential": "CFNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R733881",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R733881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00117238",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00445055",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Trunnell, CMHT
• Vonpatton'S, LLC
• Anthony Waits, R.PH.
• Ware Family Practice LLC
• Kyseta D Warner-Armstrong, LPC
• We Care Transportation, LLC
• Lakia Young, CCSS

• Nurse Practitioner in Prentiss, MS
• Providers in Prentiss, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.