Active NPI
Bruce P Prive, FNP
- Family Nurse Practitioner
- Monticello, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R739397
- Practice address
- 1065 E Broad St
Monticello, MS 39654-7703 - Phone
- (601) 587-4051
- NPI assigned
- Feb 28, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R739397 | MS | Primary |
Addresses
Primary practice location
1065 E Broad St
Monticello, MS 39654-7703
Mailing address
164A Gavin Rd
Wiggins, MS 39577-9623
Phone (228) 424-7060
Other practice location 1
3661 Sangani Blvd Ste E
Diberville, MS 39540-8707
Phone (228) 424-7060
Other practice location 2
40 Union Church Rd
Meadville, MS 39653-8336
Phone (601) 384-5801
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080626000406 | MS | Practitioner - Nurse Practitioner | 7719059344 | Reassigns benefits to 15 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Covington County Hospital
Practice addresses (Care Compare)
347 Magnolia Dr
Raleigh, MS 39153-6011
Phone (601) 374-9070
Hospital & facility affiliations
- Covington County Hospital Cah
- Greene County Hospital
- Smith County Emergency Hospital
- Ochsner Stennis Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R739397 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Sunflower County Hospital | Current | Accepting new patients | |
| South Sunflower County Hospital | Current | Accepting new patients | |
| Laird Hospital, Inc. | Family | Current | Accepting new patients |
| South Sunflower County Hospital | Current | Accepting new patients | |
| South Sunflower County Hospital | Current | Accepting new patients | |
| Laird Hospital, Inc. | Current | Accepting new patients | |
| Covington County Hospital | Current | Accepting new patients | |
| Laird Hospital, Inc. | Current | Accepting new patients | |
| Franklin County Memorial Hospital | Current | Accepting new patients | |
| South Sunflower County Hospital | Current | Accepting new patients | |
| Franklin County Memorial Hospital | Current | Accepting new patients | |
| Franklin County Memorial Hospital | Current | Accepting new patients | |
| Edgewater Urgent Medical Care, LLC | Past | Accepting new patients |
Locations
136 Main St N
Bude, MS 39630
Phone (601) 384-2394
9097 Collinsville Rd
Collinsville, MS 39325
Phone (601) 626-8874
14365 Highway 16 W
De Kalb, MS 39328
Phone (769) 486-1000
121 E Baker St
Indianola, MS 38751
Phone (601) 887-3113
40 Union Church Rd
Meadville, MS 39653
Phone (601) 384-2273
317 Highway 13 S
Morton, MS 39117
Phone (601) 732-6301
605 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-6925
347 Magnolia Dr
Raleigh, MS 39153
Phone (601) 374-9070
25117 Highway 15
Union, MS 39365
Phone (601) 774-8214
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/covingc-3983785e
Organizations & group practices 35
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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Raleigh, MS
- NPI 1003654567
MS
Hospital & facility affiliations 4
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": "1204156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705536000000",
"number": "1730358201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "164A GAVIN RD",
"city": "WIGGINS",
"state": "MS",
"postal_code": "395779623",
"telephone_number": "228-424-7060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1065 E BROAD ST",
"city": "MONTICELLO",
"state": "MS",
"postal_code": "396547703",
"telephone_number": "601-587-4051"
}
],
"practiceLocations": [
{
"address_1": "3661 Sangani Blvd Ste E",
"address_purpose": "LOCATION",
"city": "Diberville",
"state": "MS",
"postal_code": "395408707",
"country_code": "US",
"telephone_number": "228-424-7060",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "40 Union Church Rd",
"address_purpose": "LOCATION",
"city": "Meadville",
"state": "MS",
"postal_code": "396538336",
"country_code": "US",
"telephone_number": "601-384-5801",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PRIVE",
"first_name": "BRUCE",
"middle_name": "P",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-28",
"last_updated": "2024-01-18",
"certification_date": "2024-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R739397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monticello, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.