Rose Ellen Clifford, APMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Gautier, MS
NPI 1730285602 · NPPES record last updated Jul 19, 2013
Key facts
- NPI
- 1730285602
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- R835932 (MS)
- Practice address
- 3407 Shamrock CT
Gautier, MS 39553-5337 - Phone
- (228) 497-0690
- Fax
- (228) 497-1363
- NPI assigned
- Sep 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1101 Robinson St
Ocean Springs, MS 39564-3841
Phone (228) 707-1101
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061205000370 | MS | Practitioner - Nurse Practitioner | 2365441185 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R835932 | MS | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clifford Psychiatric Services | Psychiatric/Mental Health | Current |
Accepting new patients |
Locations
8933 Lorraine Rd
Ste C
Gulfport, MS 39503
Phone (228) 236-2299
1101 Robinson St
Ocean Springs, MS 39564
Phone (228) 707-1101
Interoperability endpoints
- rclifford@direct.mhg.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R835932 | MS | Yes |
Addresses
Primary practice location
3407 Shamrock CT
Gautier, MS 39553-5337
Mailing address
3407 Shamrock CT
Gautier, MS 39553-5337
Phone (601) 288-8050
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00126966 | Medicaid | MS | |
| 00018214 | Medicaid | MS |
Other names
- Rose Ellen Skrmetti
Other providers in Gautier, MS
- Children'S International, LLC
- Brenda Childress
- Deveney M.K. Ching
- Sherry Laverne Chisholm
- Robin Rae Ciriello
- Judy Shelton Cloyd
- Coast Physicians Group
- Coastal Preventative Medicine, LLC
- Rochelle Rene Cole
- Michelle C Colella
All providers in Gautier, MS · Psychiatric/Mental Health Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.