Individual provider Active NPI

Amber Snow Mackey, FNP-C

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1396520151
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906268 Issued in MS
Practice address
848 S Madison St
Tupelo, MS 38801-4905
Phone
(662) 844-4177
Fax
(662) 844-3077
NPI assigned
Aug 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 916255 MS
Family Nurse Practitioner 363LF0000X 906268 MS Primary

Addresses

Primary practice location

848 S Madison St
Tupelo, MS 38801-4905

Mailing address

848 S Madison St
Tupelo, MS 38801-4905
Phone (662) 844-4177

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
I20240417002782 MS Practitioner - Nurse Practitioner 1850730292 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
Midnight-Medical, Inc.Group PAC ID 9436284239, 2 clinicians

Practice addresses (Care Compare)

848 S Madison St
Tupelo, MS 38801-4905
Phone (662) 844-4177

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
916255MSMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Midnight-Medical, Inc. Family CurrentSince Mar 10, 2024 Accepting new patients

Locations

848 S Madison St
Tupelo, MS 38801
Phone (662) 844-4177

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1396520151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014905",
            "telephone_number": "662-844-4177",
            "fax_number": "662-844-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014905",
            "telephone_number": "662-844-4177",
            "fax_number": "662-844-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKEY",
        "first_name": "AMBER",
        "middle_name": "SNOW",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "916255",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.