Individual provider Active NPI

Melanie Christine Czup, APRN, FNP-C

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1376150920
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904115 Issued in MS
Practice address
860 S Madison St
Tupelo, MS 38801-4905
Phone
(662) 377-7150
NPI assigned
Sep 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 904115 MS Primary

Addresses

Primary practice location

860 S Madison St
Tupelo, MS 38801-4905

Mailing address

808 Varsity Dr
Tupelo, MS 38801-4613

Other names 1

  • Melanie Christine Bush Former name

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
I20211215002543 MS Practitioner - Nurse Practitioner 9739570383 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

830 S Gloster St
Tupelo, MS 38801-4934
Phone (662) 377-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
904115MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Medical Center, Inc. CurrentSince Dec 6, 2021 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Dec 6, 2021 Accepting new patients
Monroe Health Services, Inc. CurrentSince Aug 1, 2024 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Monroe Health Services, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Marion Regional Medical Center, Inc. Past Accepting new patients
Amory Surgery Clinic, PLLC Past Accepting new patients

Locations

1107 Earl Frye Blvd
Ste 3
Amory, MS 38821
Phone (662) 256-9590

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

808 Varsity Dr
Tupelo, MS 38801
Phone (662) 377-2386

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

860 S Madison St
Tupelo, MS 38801
Phone (662) 377-7150

450 E President Ave
Tupelo, MS 38801
Phone (662) 377-3204

Interoperability endpoints

  • Direct secure messaging: melaniebush@nmhs.medalliesdirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1376150920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 VARSITY DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014905",
            "telephone_number": "662-377-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZUP",
        "first_name": "MELANIE",
        "middle_name": "CHRISTINE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELANIE",
            "last_name": "BUSH",
            "middle_name": "CHRISTINE",
            "credential": "APRN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.