Andrea Carpenter, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Mantachie, MS
NPI 1780169557 · NPPES record last updated Jul 22, 2019
Key facts
- NPI
- 1780169557
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 902761 (MS)
- Practice address
- 3275 Highway 371 N
Mantachie, MS 38855-7145 - Phone
- (662) 282-7555
- Fax
- (662) 346-7074
- NPI assigned
- Sep 27, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hometown Care of Mantachie, LLC
Practice addresses (Care Compare)
3275 Hwy 371 N
Mantachie, MS 38855-7145
Phone (662) 282-7555
Hospital & facility affiliations
- North Mississippi Medical Ctr HHA
- North Mississippi Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.03 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 70.75
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 |
|---|---|---|---|---|
| I20190214002768 | MS | Practitioner - Nurse Practitioner | 9537407606 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 902761 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Care of Mantachie LLC | Family | Current |
Accepting new patients |
| Hometown Care of North Mississippi, Inc | Family | Current |
Accepting new patients |
Locations
3275 Highway 371 N
Mantachie, MS 38855
Phone (662) 282-7555
220 W Main St
Okolona, MS 38860
Phone (662) 276-5065
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FBGIBD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 902761 | MS | Yes |
Addresses
Primary practice location
3275 Highway 371 N
Mantachie, MS 38855-7145
Mailing address
3275 Highway 371 N
Mantachie, MS 38855-7145
Phone (662) 282-7555
Other practice location 1
830 S Gloster St
Tupelo, MS 38801-4934
Phone (662) 377-3270
Other providers in Mantachie, MS
- Jennifer Emily Bass
- Timmi Unger Bishop
- Austin Harbor Black
- Hannah Grace Boren
- Madison Leigh Carrell
- Nativel J Collins
- Community Family Healthcare, Inc
- Countrywood Manor Assisted Living, Inc.
- Extra Mile Recovery, LLC
All providers in Mantachie, 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 Jul 22, 2019. 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.