Morgan Hope Mahan, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

22789 Issued in TN

Practice address

19 Security Dr
Jackson, TN 38305

Phone

(731) 664-9040

Fax

(731) 664-9041

NPI assigned

Jul 14, 2017

Last updated

Apr 25, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmahan30686@mlh.direct-ci.com
• FHIR API: https://api.platform.athenahealth.com/21899/brand/1/csg/1/fhir/r4

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.

• Rainbow Pediatric PC

  • Rural Health Clinic/Center
  • Humboldt, TN
  • NPI 1255474300
  Medicare reassignment NPD

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1629590369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 HERITAGE SQ",
            "city": "MEDINA",
            "state": "TN",
            "postal_code": "383552102",
            "telephone_number": "731-414-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 SECURITY DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-664-9040",
            "fax_number": "731-664-9041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1636 E Main St",
            "address_purpose": "LOCATION",
            "city": "Humboldt",
            "state": "TN",
            "postal_code": "383432904",
            "country_code": "US",
            "telephone_number": "731-784-7833",
            "fax_number": "731-784-7856",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19 Security Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "38305",
            "country_code": "US",
            "telephone_number": "731-664-9040",
            "fax_number": "731-664-9041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "MORGAN",
        "middle_name": "HOPE",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "22789",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "22789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Kidney Clinic
• Madison Physician Group Inc
• Magnolia Care Services, LLC (MCS)
• Natasha C Mahajan, MD
• Kamran Mahalati, M.D.
• Angel S Maharrey
• Yasmin Nabil Mahmoud
• William Andrew Malec
• Roxanne Malin, LPE
• Jonathan Ray Mallette, PHARM.D.

• Pediatric Nurse Practitioner in Jackson, TN
• Providers in Jackson, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.