Mary Elizabeth Paul, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

903484 Issued in MS

Practice address

1129 Highway 35 S Ste 1
Forest, MS 39074-8829

Phone

(601) 469-3320

Fax

(601) 469-3323

NPI assigned

Sep 30, 2019

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, ND, MN, IA, WI, NY, MA, WA, MO, IL10 enrollments

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 10

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evizzit of Iowa Psychiatry PCGroup PAC ID 2860825924, 52 clinicians

Practice addresses (Care Compare)

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.

• Evizzit of Iowa Psychiatry PC

  • Psychiatry Physician
  • West Des Moines, IA
  • NPI 1740841188

  IL, MA, MN, MO, ND, Psychiatric/Mental Health, WA, WI

  Medicare reassignment Care Compare group NPD
• Independent Healthcare Management, Inc.

  • Critical Access Hospital
  • Forest, MS
  • NPI 1306909734
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• TBD Acquisition II LLC

  • Psychiatric Hospital
  • Gulfport, MS
  • NPI 1750891792
  Medicare reassignment NPD
• Broadlawns Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1467447508
  Medicare reassignment NPD
• Community Medical Associates, Inc.

  • Family Medicine Physician
  • Lawrence, MA
  • NPI 1144544040
  Medicare reassignment NPD
• Integrated Telehealth Medicine PC

  • Psychiatry Physician
  • Oceanside, NY
  • NPI 1124870233

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Watertown Physician Practices LLC

  • Family Medicine Physician
  • Watertown, WI
  • NPI 1770964363
  Medicare reassignment NPD
• Black River Health Inc

  • Critical Access Hospital
  • Black River Falls, WI
  • NPI 1811940331
  Medicare reassignment NPD (past)
• Independent Healthcare Management, Inc.

  • Rural Health Clinic/Center
  • Raleigh, MS
  • NPI 1871272724
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• TBD Acquisition II, LLC

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1003324419
  NPD

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1336780527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX D",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390740558",
            "telephone_number": "601-469-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 HIGHWAY 35 S STE 1",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390748829",
            "telephone_number": "601-469-3320",
            "fax_number": "601-469-3323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11150 Highway 49",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395034110",
            "country_code": "US",
            "telephone_number": "228-236-2117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAUL",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "903484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamatha Nicole Owen
• Charlotte C. Pace
• Sarah A Parker, RPT
• Laicon Partain
• Lotashia Patrick, PMHNP-BC
• My Quang Thi Pham, PHARM.D.
• Leanne Earls Pounders, DPT
• Ashley Powell, FNP-C
• Premise Health of Mississippi Medical PC
• Haley Huey Purvis, SLP

• Psychiatric/Mental Health Nurse Practitioner in Forest, MS
• Providers in Forest, 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 Jun 5, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.