Dana Pannell
Individual provider Active NPI Family Nurse Practitioner · Boyle, MS
NPI 1750123394 · NPPES record last updated Jun 12, 2024
Key facts
- NPI
- 1750123394
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 906691 (MS)
- Practice address
- 20 Elmwood LN
Boyle, MS 38730-9631 - Phone
- (662) 719-3119
- NPI assigned
- Jun 12, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Express Care of Cleveland, LLC
Practice addresses (Care Compare)
609 N Davis Ave
Suite 105
Cleveland, MS 38732-2379
Phone (662) 579-3958
Hospital & facility affiliations
- Bolivar Medical Center
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 |
|---|---|---|---|---|
| I20240712002036 | MS | Practitioner - Nurse Practitioner | 7719422880 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Mississippi-University of Mississippi Medical Center | Current |
Accepting new patients | |
| Grenada Physician Services, LLC | Current |
Accepting new patients | |
| State of Mississippi - University of Mississippi Medical Center | Current |
Accepting new patients | |
| Express Care of Cleveland, LLC | Current |
Accepting new patients |
Locations
609 N Davis Ave
Ste 105
Cleveland, MS 38732
Phone (662) 579-3958
960 Avent Dr
#J
Grenada, MS 38901
Phone (662) 227-6450
965 Avent Dr
Ste 100A
Grenada, MS 38901
Phone (662) 227-7000
960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000
1515 University Ave
Oxford, MS 38655
Phone (662) 238-0011
Interoperability endpoints
- dpannell219634@ummc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 906691 | MS | Yes |
Addresses
Primary practice location
20 Elmwood LN
Boyle, MS 38730-9631
Mailing address
20 Elmwood LN
Boyle, MS 38730-9631
Phone (662) 719-3119
Other providers in Boyle, MS
- Ashley Nichole Brooks
- Cleveland Transport LLC
- Yolanda H. Jackson
- North Sunflower Medical Center
- Patrick Brent Smith
- Glynn Nora Standifer
- Willie Mae Clerk Adult Day Care ,LLC
- Wisdom Adult Day Center
All providers in Boyle, MS · Family 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 Jun 12, 2024. 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.