Individual provider Active NPI

Teresa S Monroe, FNP

  • Family Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1881388684
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
905874 Issued in MS
Practice address
6766 Hwy 98W
Ste 1
Hattiesburg, MS 39402
Phone
(601) 550-3153
NPI assigned
Jun 5, 2023
Last updated
Jun 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 905874 MS Primary

Addresses

Primary practice location

6766 Hwy 98W
Ste 1
Hattiesburg, MS 39402

Mailing address

15 Keystone Dr Ste E
Hattiesburg, MS 39402-6124
Phone (601) 550-3153

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
I20230706001434 MS Practitioner - Nurse Practitioner 9931568110 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

1130 Frontage Dr W
Wiggins, MS 39577-8165
Phone (601) 716-8012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
905874MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 15, 2025 Accepting new patients
Pioneer Health Care , LLC CurrentSince Jun 15, 2023 Accepting new patients
Fast Pace Mississippi, PLLC Family CurrentSince Jun 1, 2024 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 15, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Jun 1, 2024 Accepting new patients
Conx Care Corporation PastSince Jun 11, 2023 Accepting new patients

Locations

15 Keystone Dr
Ste E
Hattiesburg, MS 39402
Phone (601) 606-6326

300 Cahal St
Hattiesburg, MS 39401
Phone (601) 582-9157

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

1130 Frontage Dr W
Wiggins, MS 39577
Phone (601) 716-8012

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8276/brand/1/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1881388684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 KEYSTONE DR STE E",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394026124",
            "telephone_number": "601-550-3153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6766 HWY 98W",
            "address_2": "STE 1",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-550-3153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONROE",
        "first_name": "TERESA",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.