Individual provider Active NPI

Brittney Evette Bracey, FNP

  • Family Nurse Practitioner
  • Foxworth, MS
National Provider Identifier
1407398845
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
901723 Issued in MS
Practice address
500 Pine Grove Church Rd
Foxworth, MS 39483-3269
Phone
(601) 731-4504
NPI assigned
Nov 16, 2016
Last updated
Nov 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 901723 MS
Family Nurse Practitioner 363LF0000X 901723 MS Primary

Addresses

Primary practice location

500 Pine Grove Church Rd
Foxworth, MS 39483-3269

Mailing address

500 Pine Grove Church Rd
Foxworth, MS 39483-3269
Phone (601) 731-4504

Other identifiers 1

IdentifierTypeStateIssuer
05954541MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bbracey57632@directpatientrecord.com Health Information Exchange (HIE)

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
I20170127000454 MS Practitioner - Nurse Practitioner 3072895051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ware Family Practice LLCGroup PAC ID 4486020633, 3 clinicians

Practice addresses (Care Compare)

972 Columbia Ave
Prentiss, MS 39474-5405
Phone (601) 543-5859

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
901723MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ware Family Practice LLC CurrentSince Oct 28, 2023 Accepting new patients

Locations

972 Columbia Ave
Prentiss, MS 39474
Phone (601) 543-5859

Interoperability endpoints

  • Direct secure messaging: bbracey57632@directpatientrecord.com

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, 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": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1407398845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PINE GROVE CHURCH RD",
            "city": "FOXWORTH",
            "state": "MS",
            "postal_code": "394833269",
            "telephone_number": "601-731-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PINE GROVE CHURCH RD",
            "city": "FOXWORTH",
            "state": "MS",
            "postal_code": "394833269",
            "telephone_number": "601-731-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACEY",
        "first_name": "BRITTNEY",
        "middle_name": "EVETTE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-16",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "901723",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05954541",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbracey57632@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "502 Broad St",
            "city": "Columbia",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394293037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Foxworth, MS

Sources for this page

Verify at the official NPI Registry.