Desiree Brooke Haugh, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R881909 Issued in MS

Practice address

103 Ridgemont Villa
Booneville, MS 38829-1010

Phone

(662) 368-3858

Fax

(662) 368-3931

NPI assigned

May 1, 2014

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2023 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: dhaugh@direct.meditouchehr.com

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1275943086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 RIDGEMONT VILLA",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388291010",
            "telephone_number": "662-368-3858",
            "fax_number": "662-368-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 RIDGEMONT VILLA",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388291010",
            "telephone_number": "662-368-3858",
            "fax_number": "662-368-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGH",
        "first_name": "DESIREE",
        "middle_name": "BROOKE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-01",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R881909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Hall
• Hancock Internal Medicine Services, LLC
• Mary Grace Hancock, M.D.
• Michael Hancock, M.D.
• Kim Latice Harvey-Cooper, LPC
• Beth Haynes, R.N.
• Health Care Plus
• Heart to Heart Hospice of Booneville LLC
• Paul Walter Henderson
• Shirley C Henderson, L.P.N.

• Family Nurse Practitioner in Booneville, MS
• Providers in Booneville, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.