Individual provider Active NPI

Marlana Huffstatler, CFNP

  • Family Nurse Practitioner
  • Pontotoc, MS
National Provider Identifier
1477955177
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R877004 Issued in MS
Practice address
109 Highway 15 S
Pontotoc, MS 38863-2628
Phone
(662) 509-9934
Fax
(662) 509-9935
NPI assigned
Sep 24, 2014
Last updated
Aug 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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 R877004 MS Primary

Addresses

Primary practice location

109 Highway 15 S
Pontotoc, MS 38863-2628

Mailing address

109 Highway 15 S
Pontotoc, MS 38863-2628
Phone (662) 509-9934

Other identifiers 1

IdentifierTypeStateIssuer
05830268MedicaidMS

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
I20150216000960 MS Practitioner - Nurse Practitioner 7113242116 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4566 S Eason Blvd
OB/GYN Nurse Practitioners
Tupelo, MS 38801-6540
Phone (662) 377-4989

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Current Accepting new patients
Lindsay Clinic PA Family CurrentSince Jan 1, 2015 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Jan 14, 2020 Accepting new patients
North Mississippi Medical Center, Inc. CurrentSince Jan 14, 2020 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Medical Center Past Accepting new patients
Alliance Rehabilitation, Inc Past Accepting new patients

Locations

109 Highway 15 S
Pontotoc, MS 38863
Phone (662) 308-5236

4381 S Eason Blvd
Ste 101
Tupelo, MS 38801
Phone (662) 377-4054

4566 S Eason Blvd
Tupelo, MS 38801
Phone (662) 377-4962

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: marlanahuffstatler@nmhs.medalliesdirect.net

Organizations & group practices 7

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": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1477955177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 HIGHWAY 15 S",
            "city": "PONTOTOC",
            "state": "MS",
            "postal_code": "388632628",
            "telephone_number": "662-509-9934",
            "fax_number": "662-509-9935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 HIGHWAY 15 S",
            "city": "PONTOTOC",
            "state": "MS",
            "postal_code": "388632628",
            "telephone_number": "662-509-9934",
            "fax_number": "662-509-9935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFFSTATLER",
        "first_name": "MARLANA",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R877004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05830268",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontotoc, MS

Sources for this page

Verify at the official NPI Registry.