Individual provider Active NPI

Presley Dyess Stovall

  • Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1376342790
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
900126 Issued in MS
Practice address
670 Weathersby Rd Ste 140
Hattiesburg, MS 39402-9586
Phone
(601) 318-0669
NPI assigned
Mar 10, 2025
Last updated
Jan 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 900126 MS Primary

Addresses

Primary practice location

670 Weathersby Rd Ste 140
Hattiesburg, MS 39402-9586

Mailing address

84 Madison PL
Hattiesburg, MS 39402-8328
Phone (601) 455-0251

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
I20250507003609 MS Practitioner - Nurse Practitioner 4789101247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Systems Management, LLCGroup PAC ID 5092964643, 49 clinicians

Practice addresses (Care Compare)

129 Ctr St
Suite B
Richland, MS 39218-4800
Phone (769) 233-7141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
900126MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ap Med L L C CurrentSince Mar 20, 2025 Accepting new patients
Medical Systems Management LLC CurrentSince Apr 4, 2025 Accepting new patients
Apex Prime Health Solutions LLC Past Accepting new patients

Locations

2200 Hardy St
Ste 30
Hattiesburg, MS 39401
Phone (601) 318-0669

670 Weathersby Rd
Ste 140
Hattiesburg, MS 39402
Phone (601) 318-0669

129 Center St
Ste B
Richland, MS 39218
Phone (769) 233-7141

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1376342790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 MADISON PL",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028328",
            "telephone_number": "601-455-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 WEATHERSBY RD STE 140",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394029586",
            "telephone_number": "601-318-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "PRESLEY",
        "middle_name": "DYESS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "900126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.