Individual provider Active NPI

Stephanie Brooke Reeves, FNP

  • Family Nurse Practitioner
  • Amory, MS
National Provider Identifier
1508335878
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903036 Issued in MS
Practice address
1208 Guy Pickle Rd
Amory, MS 38821-8212
Phone
(662) 256-3120
Fax
(662) 256-7092
NPI assigned
Nov 16, 2018
Last updated
Nov 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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 903036 MS Primary

Addresses

Primary practice location

1208 Guy Pickle Rd
Amory, MS 38821-8212

Mailing address

1208 Guy Pickle Rd
Amory, MS 38821-8212
Phone (662) 256-3120

Other identifiers 1

IdentifierTypeStateIssuer
07939361MedicaidMS

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
I20200720000399 MS Practitioner - Nurse Practitioner 8820412265 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

Practice addresses (Care Compare)

203 5TH Ave S
Amory, MS 38821-4216
Phone (662) 825-0987

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
903036MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bliss Health and Wellness LLC CurrentSince Aug 29, 2024 Accepting new patients
Weekends Plus Urgent Care LLC CurrentSince Aug 1, 2023 Accepting new patients
Access Family Health Services, Inc. Past Accepting new patients

Locations

203 5th Ave S
Amory, MS 38821
Phone (662) 825-0987

3189 Highway 45 N
#H
Columbus, MS 39705
Phone (662) 240-2975

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16677/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1542326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1508335878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 GUY PICKLE RD",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388218212",
            "telephone_number": "662-256-3120",
            "fax_number": "662-256-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 GUY PICKLE RD",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388218212",
            "telephone_number": "662-256-3120",
            "fax_number": "662-256-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVES",
        "first_name": "STEPHANIE",
        "middle_name": "BROOKE",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-16",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07939361",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amory, MS

Sources for this page

Verify at the official NPI Registry.