Individual provider Active NPI

Christopher Harvey Bracey, FNP

  • Family Medicine Physician
  • McComb, MS
National Provider Identifier
1578084521
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
902112 Issued in MS
Practice address
1017 Delaware Ave
McComb, MS 39648-3827
Phone
(601) 250-1122
Fax
(601) 250-0290
NPI assigned
Jun 29, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 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 Medicine Physician 207Q00000X 902112 MS Primary

Addresses

Primary practice location

1017 Delaware Ave
McComb, MS 39648-3827

Mailing address

1017 Delaware Ave
McComb, MS 39648-3827
Phone (601) 250-1122

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
I20170830001450 MS Practitioner - Nurse Practitioner 8426321258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Statcare PLLCGroup PAC ID 5799764965, 9 clinicians

Practice addresses (Care Compare)

208 W Presley Boulevard a
Plus One Medical Clinic
McComb, MS 39648-5524
Phone (601) 465-0745

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
902112MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Statcare PLLC CurrentSince Jul 15, 2017 Accepting new patients
Statcare PLLC Family Medicine CurrentSince Jul 15, 2017 Accepting new patients

Locations

1015 Delaware Ave
Ste C
McComb, MS 39648
Phone (601) 249-4777

1017 Delaware Ave
McComb, MS 39648
Phone (601) 250-1122

208 W Presley Blvd
#A
McComb, MS 39648
Phone (601) 465-0745

Interoperability endpoints

  • Direct secure messaging: cbracey@sp-ms.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1578084521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 DELAWARE AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483827",
            "telephone_number": "601-250-1122",
            "fax_number": "601-250-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 DELAWARE AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483827",
            "telephone_number": "601-250-1122",
            "fax_number": "601-250-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACEY",
        "first_name": "CHRISTOPHER",
        "middle_name": "HARVEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "902112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.