Individual provider Active NPI

Melia Fortenberry, NP

  • Acute Care Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1376391268
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
906647 Issued in MS
Practice address
1314 19TH Ave
Meridian, MS 39301-4116
Phone
(601) 703-9590
NPI assigned
May 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 906647 MS Primary

Addresses

Primary practice location

1314 19TH Ave
Meridian, MS 39301-4116

Mailing address

3334 Highway 496
Meridian, MS 39301-7120
Phone (601) 479-4766

Other practice location 1

7048 Old Canton Rd Ste 2E
Ridgeland, MS 39157-1021
Phone (601) 992-9790

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
I20240925000637 MS Practitioner - Nurse Practitioner 6507307923 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern Medical Consultants LLCGroup PAC ID 9830496314, 19 clinicians
Medical Foundation IncGroup PAC ID 9234043712, 211 clinicians

Practice addresses (Care Compare)

108 Four Lane Hwy 49
Bentonia, MS 39040-9433
Phone (662) 998-8900

1800 12TH St
Meridian, MS 39301-4158
Phone (601) 484-6700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Medical Consultants LLC CurrentSince Jun 8, 2024 Accepting new patients
Medical Foundation, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Medical Foundation, Inc. Acute Care CurrentSince Sep 1, 2024 Accepting new patients

Locations

108 Four LN Hwy 49
Bentonia, MS 39040
Phone (662) 998-8900

2401 16th St
Meridian, MS 39301
Phone (601) 482-4181

1800 12th St
Meridian, MS 39301
Phone (601) 483-0011

1314 19th Ave
Meridian, MS 39301
Phone (601) 483-0011

7048 Old Canton Rd
Ste 2E
Ridgeland, MS 39157
Phone (601) 919-0972

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 4

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": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1376391268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 HIGHWAY 496",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393017120",
            "telephone_number": "601-479-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 19TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014116",
            "telephone_number": "601-703-9590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7048 Old Canton Rd Ste 2E",
            "address_purpose": "LOCATION",
            "city": "Ridgeland",
            "state": "MS",
            "postal_code": "391571021",
            "country_code": "US",
            "telephone_number": "601-992-9790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTENBERRY",
        "first_name": "MELIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "906647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.