Individual provider Active NPI

Debora Fields McFalls, CFNP

  • Family Nurse Practitioner
  • Corinth, MS
National Provider Identifier
1386679579
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R582662 Issued in MS
Practice address
1801 S Harper Rd Ste 7
Corinth, MS 38834-6726
Phone
(662) 286-2300
Fax
(662) 286-7010
NPI assigned
Jul 12, 2006
Last updated
May 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

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 R582662 MS Primary

Addresses

Primary practice location

1801 S Harper Rd Ste 7
Corinth, MS 38834-6726

Mailing address

150 County Road 255
Glen, MS 38846-9227
Phone (662) 287-0301

Other identifiers 2

IdentifierTypeStateIssuer
00656871MedicaidMS
0121943MedicaidMS

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
I20040719001384 MS Practitioner - Nurse Practitioner 6800878356 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R582662MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Family Health Clinic LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

2427 Proper St
Corinth, MS 38834
Phone (662) 286-2300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1386679579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 COUNTY ROAD 255",
            "city": "GLEN",
            "state": "MS",
            "postal_code": "388469227",
            "telephone_number": "662-287-0301",
            "fax_number": "662-286-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S HARPER RD STE 7",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388346726",
            "telephone_number": "662-286-2300",
            "fax_number": "662-286-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCFALLS",
        "first_name": "DEBORA",
        "middle_name": "FIELDS",
        "name_prefix": "Mrs.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R582662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00656871",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0121943",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.