Amanda Brooke Roach, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

902996 Issued in MS

Practice address

544 Keyway Dr Ste a
Flowood, MS 39232-9580

Phone

(601) 487-0840

NPI assigned

Oct 19, 2018

Last updated

Oct 21, 2021By the provider in NPPES

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

Enrolled in MS, LA2 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 2

Specialty

Nurse Practitioner

Education

University of Mississippi School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Positive Pathways, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vicksburg, MS
  • NPI 1801335492
  Medicare reassignment NPD
• Right Track Medical Group, Inc

  • Psychiatry Physician
  • Olive Branch, MS
  • NPI 1972080257
  Medicare reassignment NPD
• Louisiana Health Care Practitioners LLC

  dba Mansura Family Clinic

  • Rural Health Clinic/Center
  • Mansura, LA
  • NPI 1811065220
  Medicare reassignment
• MDB Behavioral Health Services LLC

  dba Complete Care Rural Health Clinic

  • Rural Health Clinic/Center
  • Vicksburg, MS
  • NPI 1669835310
  Care Compare group

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1366918195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 KEYWAY DR STE A",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329580",
            "telephone_number": "662-419-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 KEYWAY DR STE A",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329580",
            "telephone_number": "601-487-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "AMANDA",
        "middle_name": "BROOKE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2021-10-21",
        "certification_date": "2021-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "902996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• River Oaks Management Company, LLC (River Oaks Cardiology)
• Riverbend Pharmacy LLC
• Lauren Leigh Rivers
• Robert Wayne Rives, D.D.S.
• Shannon Rives, N.P.
• Kenny K Robbins, MD
• Lauren Elizabeth Roberts, DPT
• Lindsey Roberts, FNP
• Ronald Brent Roberts, MD
• John Houston Robertson, PT, DPT

• Psychiatric/Mental Health Nurse Practitioner in Flowood, MS
• Providers in Flowood, 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 Oct 21, 2021; 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.