Individual provider Active NPI

Candace Eaton Mauney, FNP

  • Nurse Practitioner
  • New Albany, MS
National Provider Identifier
1366709685
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
904790 Issued in MS
Practice address
452 W Bankhead St
New Albany, MS 38652-3319
Phone
(662) 534-7474
Fax
(662) 534-7100
NPI assigned
Apr 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 904790 MS Primary
Registered Nurse 163W00000X R888400 MS

Addresses

Primary practice location

452 W Bankhead St
New Albany, MS 38652-3319

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401

Other practice location 1

2441A County Road 501
Ripley, MS 38663-9677
Phone (662) 837-8154

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
I20210915002113 MS Practitioner - Nurse Practitioner 1153727235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

255 Baptist Blvd
Columbus, MS 39705-2006

452 W Bankhead St
New Albany, MS 38652-3319
Phone (662) 534-3724

456 W Bankhead St
New Albany, MS 38652-3319
Phone (662) 534-7474

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R888400MSMDRegistered Nurse
904790MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc CurrentSince Aug 8, 2021 Accepting new patients
Baptist Memorial Medical Group Inc Nurse Practitioner CurrentSince Aug 8, 2021 Accepting new patients
Baptist Memorial Health Services, Inc. of Mississippi Past Accepting new patients

Locations

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

452 W Bankhead St
New Albany, MS 38652
Phone (601) 968-8132

8138 Country Village Dr
Cordova, TN 38016
Phone (901) 725-8606

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

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 1

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": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1366709685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 W BANKHEAD ST",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523319",
            "telephone_number": "662-534-7474",
            "fax_number": "662-534-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2441A County Road 501",
            "address_purpose": "LOCATION",
            "city": "Ripley",
            "state": "MS",
            "postal_code": "386639677",
            "country_code": "US",
            "telephone_number": "662-837-8154",
            "fax_number": "662-837-9462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAUNEY",
        "first_name": "CANDACE",
        "middle_name": "EATON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "904790",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "R888400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, MS

Sources for this page

Verify at the official NPI Registry.