Individual provider Active NPI

Audrey Alexander, NP

  • Nurse Practitioner
  • Morton, MS
National Provider Identifier
1396586186
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
906399 Issued in MS
Practice address
96 Old Highway 80 E
Morton, MS 39117-9771
Phone
(731) 394-1145
NPI assigned
Jun 4, 2024
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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 906399 MS Primary

Addresses

Primary practice location

96 Old Highway 80 E
Morton, MS 39117-9771

Mailing address

178 Bufkins Rd
Walnut Grove, MS 39189-6001
Phone (601) 826-2948

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
I20240925003775 MS Practitioner - Nurse Practitioner 9436690831 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
Group practices
Southern Health Corp of Houston, Inc.Group PAC ID 0042102352, 10 clinicians
Progressive Health of Houston LLCGroup PAC ID 0143662429, shared by 4 NPIs, 17 clinicians
Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians

Practice addresses (Care Compare)

1002 E Madison St
Houston, MS 38851-2428

96 Old Hwy 80 E
Mississippi Care Center of Morton
Morton, MS 39117-9771
Phone (731) 394-1145

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
906399MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Health LLC Nurse Practitioner CurrentSince Sep 9, 2024 Accepting new patients

Locations

156 E Walnut Ave
Eupora, MS 39744
Phone (662) 258-8293

1220 E Northside Dr
Ste 170
Jackson, MS 39211
Phone (601) 394-8209

96 Old Highway 80 E
Morton, MS 39117
Phone (601) 543-8772

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

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.

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": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1396586186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 BUFKINS RD",
            "city": "WALNUT GROVE",
            "state": "MS",
            "postal_code": "391896001",
            "telephone_number": "601-826-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 OLD HIGHWAY 80 E",
            "city": "MORTON",
            "state": "MS",
            "postal_code": "391179771",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "AUDREY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "906399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, MS

Sources for this page

Verify at the official NPI Registry.