Individual provider Active NPI

Mandy Michelle Carter, ACNP

  • Acute Care Nurse Practitioner
  • Texarkana, TX
National Provider Identifier
1699066969
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
001653 Issued in TX
Practice address
921 Texas Blvd Ste D
Texarkana, TX 75501-5163
Phone
(903) 792-3660
NPI assigned
Apr 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 001653 TX Primary

Addresses

Primary practice location

921 Texas Blvd Ste D
Texarkana, TX 75501-5163

Mailing address

921 Texas Blvd Ste D
Texarkana, TX 75501-5163
Phone (903) 792-3660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160825002088 TX Practitioner - Nurse Practitioner 1759569759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonary Diseases Medicine ClinicGroup PAC ID 6103989025, 2 clinicians

Practice addresses (Care Compare)

921 Texas Blvd
Texarkana, TX 75501-5163
Phone (903) 792-3660

Hospital & facility affiliations

  • Encompass Health Home Health Home health agency, Texarkana, AR, CCN 047168
  • Enhabit Home Health Home health agency, Longview, TX, CCN 679079
  • Elite Home Health Home health agency, Nashville, AR, CCN 047138
  • Little River Memorial Hospital Home Health Home health agency, Ashdown, AR, CCN 047139
  • Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
  • Little River Memorial Hospital Hospital, Ashdown, AR, CCN 041320

Merit-based Incentive Payment System (MIPS)

Final score
72 of 100Reported as group
Quality
37.83
Improvement activities
40
Cost
70.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001653TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Diseases Medicine Clinic CurrentSince May 18, 2011 Accepting new patients

Locations

921 Texas Blvd
Ste D
Texarkana, TX 75501
Phone (903) 792-3660

Interoperability endpoints

  • Direct secure messaging: mandycarter@2291c32e.micromddirect.com

Organizations & group practices 1

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 7

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": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1699066969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 TEXAS BLVD STE D",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015163",
            "telephone_number": "903-792-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 TEXAS BLVD STE D",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015163",
            "telephone_number": "903-792-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "MANDY",
        "middle_name": "MICHELLE",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-21",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "001653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.