Individual provider Active NPI

Mandy Michelle Ward, APRN, FNP-BC

  • Family Nurse Practitioner
  • Mountain City, TN
National Provider Identifier
1669214474
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
36421 Issued in TN
Practice address
1025 Slimp Branch Rd
Mountain City, TN 37683-6578
Phone
(423) 444-9924
NPI assigned
Jun 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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 36421 TN Primary

Addresses

Primary practice location

1025 Slimp Branch Rd
Mountain City, TN 37683-6578

Mailing address

1025 Slimp Branch Rd
Mountain City, TN 37683-6578
Phone (423) 444-9924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20241227000508 NC Practitioner - Nurse Practitioner 5597292862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watauga Medical Center IncGroup PAC ID 2668377474, 95 clinicians

Practice addresses (Care Compare)

336 Deerfield Rd
Boone, NC 28607-5008
Phone (828) 263-4133

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36421TNMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Watauga Medical Center Inc CurrentSince Nov 13, 2024 Accepting new patients
Watauga Medical Center, Inc. Current Accepting new patients
Watauga Medical Center Inc CurrentSince Nov 13, 2024 Accepting new patients
Watauga Medical Center, Inc. Past Accepting new patients

Locations

336 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

169 Doctors Dr
Boone, NC 28607
Phone (828) 262-9520

Interoperability endpoints

  • Direct secure messaging: mward1159570@direct.unc.nchie.net

Organizations & group practices 4

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 3

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": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1669214474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 SLIMP BRANCH RD",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376836578",
            "telephone_number": "423-444-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 SLIMP BRANCH RD",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376836578",
            "telephone_number": "423-444-9924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "MANDY",
        "middle_name": "MICHELLE",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "36421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain City, TN

Sources for this page

Verify at the official NPI Registry.