Individual provider Active NPI

Monica McCarley, F.N.P.

  • Pediatric Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1770928707
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
853832 Issued in MS
Practice address
942 Commonwealth Blvd
Tupelo, MS 38804-9762
Phone
(662) 620-0101
Fax
(662) 620-0195
NPI assigned
May 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 853832 MS Primary

Addresses

Primary practice location

942 Commonwealth Blvd
Tupelo, MS 38804-9762

Mailing address

850 Poplar Ave
Memphis, TN 38105

Other names 1

  • Monica Mathews Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190626000249 MS Practitioner - Nurse Practitioner 3173857109 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Lebonheur Pediatric Specialists, Inc. CurrentSince Apr 30, 2019 Accepting new patients

Locations

610 Brunson Dr
Tupelo, MS 38801
Phone (601) 844-7211

942 Commonwealth Blvd
Tupelo, MS 38804
Phone (662) 620-0101

850 Poplar Ave
Memphis, TN 38105
Phone (901) 287-5594

850 Poplar Ave
Bldg 2
Memphis, TN 38105
Phone (901) 287-5594

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1770928707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 COMMONWEALTH BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388049762",
            "telephone_number": "662-620-0101",
            "fax_number": "662-620-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARLEY",
        "first_name": "MONICA",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-03",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "853832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONICA",
            "last_name": "MATHEWS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.