Individual provider Active NPI

Abby Sutton, FNP C

  • Family Nurse Practitioner
  • Eupora, MS
National Provider Identifier
1790067486
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R619264 Issued in MS
Practice address
70 Medical PLZ
Eupora, MS 39744-4018
Phone
(662) 258-9400
NPI assigned
Sep 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R619264 MS
Family Nurse Practitioner 363LF0000X R619264 MS Primary

Addresses

Primary practice location

70 Medical PLZ
Eupora, MS 39744-4018

Mailing address

911 Tyler Dr
Tupelo, MS 38801-5745
Phone (662) 680-9368

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
I20111109000450 MS Practitioner - Nurse Practitioner 1052584992 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R619264MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Hospitalists of Ms, LLC CurrentSince Mar 1, 2016 Accepting new patients
Comprehensive Hospitalists of Ms, LLC Current Accepting new patients
Webster Health Services, Inc. CurrentSince Apr 1, 2016 Accepting new patients
Webster Health Services, Inc. CurrentSince Apr 1, 2016 Accepting new patients
Webster Health Services, Inc. Current Accepting new patients

Locations

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

1301 Veterans Memorial Blvd
Eupora, MS 39744
Phone (662) 258-7200

70 Medical Plz
Eupora, MS 39744
Phone (662) 258-6221

Organizations & group practices 5

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": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1790067486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 TYLER DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015745",
            "telephone_number": "662-680-9368",
            "fax_number": "662-842-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MEDICAL PLZ",
            "city": "EUPORA",
            "state": "MS",
            "postal_code": "397444018",
            "telephone_number": "662-258-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "ABBY",
        "credential": "FNP C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-19",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R619264",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R619264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eupora, MS

Sources for this page

Verify at the official NPI Registry.