Individual provider Active NPI

Marian Boykin, FNP

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1497223317
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902884 Issued in MS
Practice address
845 S Madison St
Tupelo, MS 38801-4905
Phone
(662) 377-5930
NPI assigned
Nov 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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 902884 MS Primary

Addresses

Primary practice location

845 S Madison St
Tupelo, MS 38801-4905

Mailing address

60007 C and C LN
Smithville, MS 38870-9105

Other identifiers 1

IdentifierTypeStateIssuer
363LF0000XOtherMSTAXONOMY

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
I20181128002585 MS Practitioner - Nurse Practitioner 1759625940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

408 Council Cir
Suite a
Tupelo, MS 38801-4949
Phone (662) 377-1130

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Clinics Inc Family CurrentSince Nov 1, 2018 Accepting new patients
North Mississippi Medical Clinics Inc CurrentSince Nov 1, 2018 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Aug 1, 2019 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Medical Center, Inc. Family CurrentSince Aug 1, 2019 Accepting new patients

Locations

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

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

408 Council Cir
Ste A
Tupelo, MS 38801
Phone (662) 377-1130

Organizations & group practices 5

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.

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": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1497223317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60007 C AND C LN",
            "city": "SMITHVILLE",
            "state": "MS",
            "postal_code": "388709105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014905",
            "telephone_number": "662-377-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYKIN",
        "first_name": "MARIAN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "363LF0000X",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.