NPIMap

Individual provider Active NPI

Samuel Dean Seeley, CFNP

  • Family Nurse Practitioner
  • Ruleville, MS
National Provider Identifier
1699717249
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R857764 Issued in MS
Practice address
840 N Oak Ave
Ruleville, MS 38771-3227
Phone
(662) 756-4024
Fax
(662) 756-4114
NPI assigned
Jun 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 R857764 MS Primary

Addresses

Primary practice location

840 N Oak Ave
Ruleville, MS 38771-3227

Mailing address

840 N Oak Ave
Ruleville, MS 38771-3227
Phone (662) 756-4024

Other identifiers 3

IdentifierTypeStateIssuer
000124089MedicaidMS
COO727OtherMSPART B PHYSICIAN PRO FEE
9013863MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041101000884 MS Practitioner - Nurse Practitioner 4082676192 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Sunflower Medical Center 46 clinicians

Practice addresses (Care Compare)

202 S Ruby Ave
Ruleville, MS 38771-3227
Phone (662) 756-2500

840 N Oak Ave
Ruleville, MS 38771-3227

860 N Oak Ave
Ruleville, MS 38771-3227

Hospital & facility affiliations

  • North Sunflower Medical Center Cah Hospital, Ruleville, MS, CCN 251318
  • Bolivar Medical Center Hospital, Cleveland, MS, CCN 250093

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R857764MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Sunflower Medical Center CurrentSince Oct 8, 2006 Accepting new patients
North Sunflower Medical Center CurrentSince Mar 24, 2017 Accepting new patients
North Sunflower Medical Center Current Accepting new patients
North Sunflower Medical Center CurrentSince Oct 8, 2006 Accepting new patients
United Emergency Services, Inc. Past Accepting new patients

Locations

840 N Oak Ave
Ruleville, MS 38771
Phone (601) 756-2711

Interoperability endpoints

  • Direct secure messaging: samuelseeley@nsfmc.allscriptsdirect.net

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1699717249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 N OAK AVE",
            "city": "RULEVILLE",
            "state": "MS",
            "postal_code": "387713227",
            "telephone_number": "662-756-4024",
            "fax_number": "662-756-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N OAK AVE",
            "city": "RULEVILLE",
            "state": "MS",
            "postal_code": "387713227",
            "telephone_number": "662-756-4024",
            "fax_number": "662-756-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEELEY",
        "first_name": "SAMUEL",
        "middle_name": "DEAN",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R857764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000124089",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PART B PHYSICIAN PRO FEE",
            "identifier": "COO727",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9013863",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruleville, MS

Sources for this page

Verify at the official NPI Registry.