Individual provider Active NPI

Mary Gadus, FNP

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1538638390
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902943 Issued in MS
Practice address
830 S Gloster St
Tupelo, MS 38801-4934
Phone
(662) 377-3000
NPI assigned
Nov 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 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 902943 MS Primary

Addresses

Primary practice location

830 S Gloster St
Tupelo, MS 38801-4934

Mailing address

76 Watling Way
Columbus, MS 39705-3089
Phone (205) 567-9282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20240123000238 AL Practitioner - Nurse Practitioner 0446596118 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Eminence Urgent Care LLCGroup PAC ID 5991105561, 10 clinicians

Practice addresses (Care Compare)

2156 Hwy 52 E
Suite 150
Pelham, AL 35124-6021
Phone (205) 920-1211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
902943MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eminence Urgent Care LLC CurrentSince Oct 12, 2024 Accepting new patients
Advantage Family Care Inc CurrentSince Jan 11, 2024 Accepting new patients
Advantage Family Care, Inc. CurrentSince Jan 11, 2024 Accepting new patients
Cornerstone Primary Care LLC CurrentSince Feb 25, 2025 Accepting new patients
St. David's Carenow Urgent Care PLLC Past Accepting new patients

Locations

233 Beverly Dr
Ste 141
Calera, AL 35040
Phone (205) 651-0345

233 Beverly Dr
Ste 101
Calera, AL 35040
Phone (205) 821-4411

1115 Beltline Rd SE
Ste 400
Decatur, AL 35601
Phone (256) 898-3004

1989 Montgomery Hwy
Hoover, AL 35244
Phone (659) 599-9512

1539 Montgomery Hwy
Ste 101
Hoover, AL 35216
Phone (659) 599-9513

2156 Highway 52 E
#150
Pelham, AL 35124
Phone (205) 920-1211

30 Burton Hills Blvd
Ste 175
Nashville, TN 37215
Phone (615) 988-2014

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BDEIDD

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1538638390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 WATLING WAY",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397053089",
            "telephone_number": "205-567-9282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-377-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADUS",
        "first_name": "MARY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.