Mandy H Windham, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R872654 Issued in MS

Practice address

1746 C Ms State Hwy 1 South
Greenville, MS 38701-6304

Phone

(662) 743-9809

Fax

(662) 743-9811

NPI assigned

Oct 5, 2011

Last updated

May 12, 2016By 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 1

Addresses

Other identifiers 1

Other names 1

• Miss Mandy Nicole Hattaway Former name

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ear Nose and Throat Consultants of North Mississippi PLLCGroup PAC ID 8426136961, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.98 of 100Reported as group

Quality

100

Improvement activities

40

Cost

66.59

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7115/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.

• Ear Nose & Throat Consultants of North Mississippi PLLC

  • Otolaryngology Physician
  • Oxford, MS
  • NPI 1265646368
  Medicare reassignment Care Compare group NPD
• River Oaks Management Company LLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1922029040
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• Careplus Lakeview Family Medicine

  • Family Medicine Physician
  • Clinton, MS
  • NPI 1942621024
  NPD
• Reservoir Family Medical Clinic, PA

  • Family Medicine Physician
  • Flowood, MS
  • NPI 1770929713
  NPD
• River Oaks Management Company, LLC

  dba Hinds Internal Medicine

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1295926020
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• State of Mississippi-University of Mississippi Medical Center

  dba University of Mississippi Medical Center-Grenada Specialty Clinic

  • Family Medicine Physician
  • Grenada, MS
  • NPI 1932538527
  NPD

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1689958902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 STONE CREEK BLVD",
            "address_2": "STE 500",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328205",
            "telephone_number": "769-235-2941",
            "fax_number": "601-939-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1746 C MS STATE HWY 1 SOUTH",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387016304",
            "telephone_number": "662-743-9809",
            "fax_number": "662-743-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDHAM",
        "first_name": "MANDY",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R872654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R872654",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "HATTAWAY",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joann Wilson
• Joyce Y Wilson, SLA
• Cha'Ron Keontya Watt Winder
• Lacrystal Winder
• Octavia Rochelle Winder, LPC
• Eustace Harold Winn III, DMD
• Caldwell E Winston Jr., MS CMHT
• Women & Pediatric Clinic
• Brunswick Royalton Wong, O.D.
• Pamela C. Woods, CNA

• Family Nurse Practitioner in Greenville, MS
• Providers in Greenville, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.