NPIMap

Individual provider Active NPI

Mandy Yvette Munn, FNP

  • Family Nurse Practitioner
  • Waynesboro, MS
National Provider Identifier
1285249573
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904109 Issued in MS
Practice address
1008 Azalea Dr
Waynesboro, MS 39367-2499
Phone
(601) 509-2584
NPI assigned
Sep 13, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 13

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 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Healthcare Management Inc 32 clinicians

Practice addresses (Care Compare)

9427 Eastside Dr Ext
Suite a
Newton, MS 39345-8063
Phone (601) 681-0330

Hospital & facility affiliations

  • Accentcare Home Health of Carthage Home health agency, Carthage, MS, CCN 257129
  • S E Lackey Memorial Hospital Hospital, Forest, MS, CCN 251300
  • Ochsner Laird Hospital Hospital, Union, MS, CCN 251322
  • Ochsner Rush Hospital Hospital, Meridian, MS, CCN 250069
  • Anderson Regional Medical Center Hospital, Meridian, MS, CCN 250104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20210121000117 MS Practitioner - Nurse Practitioner 5496169146 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
904109MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Healthcare Management, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Independent Healthcare Management, Inc. CurrentSince Apr 1, 2021 Accepting new patients
Independent Healthcare Management, Inc CurrentSince Apr 1, 2021 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Jan 1, 2021 Accepting new patients
Fast Pace Mississippi, PLLC Family CurrentSince Jan 1, 2021 Accepting new patients
The Headache Center, PLLC Family PastSince Sep 1, 2020 Accepting new patients

Locations

1 Medical Ln
Ste B
Forest, MS 39074
Phone (601) 469-4861

526 Deerfield Dr
Unit C
Forest, MS 39074
Phone (601) 469-0291

330 N Broad St
#S
Forest, MS 39074
Phone (601) 469-4151

330 N Broad St
Forest, MS 39074
Phone (601) 469-4151

700 Sunset Dr
Grenada, MS 38901
Phone (662) 307-2884

376 Simpson Highway 149
Ste 300
Magee, MS 39111
Phone (601) 721-8985

110 Pioneer Way
Magee, MS 39111

347 S Fourth St
Morton, MS 39117
Phone (601) 732-1524

9427 Eastside Drive Ext
#A
Newton, MS 39345
Phone (601) 681-0330

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

1008 Azalea Dr
Waynesboro, MS 39367
Phone (601) 509-2584

Interoperability endpoints

  • Direct secure messaging: mandy.munn@phspch.eclinicaldirectplus.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 904109 MS Primary

Addresses

NPPES NPI Registry

Primary practice location

1008 Azalea Dr
Waynesboro, MS 39367-2499

Mailing address

1008 Azalea Dr
Waynesboro, MS 39367-2499
Phone (601) 509-2584

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 18, 2020.

{
    "created_epoch": "1599955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1285249573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 AZALEA DR",
            "city": "WAYNESBORO",
            "state": "MS",
            "postal_code": "393672499",
            "telephone_number": "601-509-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 AZALEA DR",
            "city": "WAYNESBORO",
            "state": "MS",
            "postal_code": "393672499",
            "telephone_number": "601-509-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNN",
        "first_name": "MANDY",
        "middle_name": "YVETTE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-13",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, MS

Sources for this page

Verify at the official NPI Registry.