Individual provider Active NPI

Mary Yates

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1629449798
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R882506 Issued in MS
Practice address
830 S Gloster St
Tupelo, MS 38801-4934
Phone
(662) 377-3000
NPI assigned
Oct 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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 R882506 MS Primary

Addresses

Primary practice location

830 S Gloster St
Tupelo, MS 38801-4934

Mailing address

830 S Gloster St
Tupelo, MS 38801-4934
Phone (662) 663-0202

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
I20161110000716 MS Practitioner - Nurse Practitioner 7012296288 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Mississippi Electrophysiology, LLCGroup PAC ID 5799068003, 7 clinicians

Practice addresses (Care Compare)

499 Gloster Creek VLG
Suite A2
Tupelo, MS 38801-4749
Phone (662) 620-6800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R882506MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Electrophysiology, LLC CurrentSince Jan 1, 2017 Accepting new patients
North Mississippi Medical Center CurrentSince Sep 12, 2016 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Sep 12, 2016 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients

Locations

1205 Highway 182 W
Starkville, MS 39759
Phone (662) 320-8545

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

499 Gloster Creek Vlg
Ste A2
Tupelo, MS 38801
Phone (662) 620-6800

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

Interoperability endpoints

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

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": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1629449798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-663-0202"
        },
        {
            "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": "YATES",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R882506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.