Mandy Marie Wright, AGACNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

71006822A Issued in IN

Practice address

520 Mary St Ste 520
Evansville, IN 47710-1682

Phone

(812) 424-8231

Fax

(812) 435-8794

NPI assigned

Oct 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Mandy Marie Fullington Former name

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwright17645@direct.deaconess.com

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.

• Deaconess Clinic Inc.

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1619123585

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Deaconess Clinic Inc

  • Pediatrics Physician
  • Washington, IN
  • NPI 1356132310

  Nurse Practitioner

  NPD
• Deaconess Clinic, Inc

  • Infectious Disease Physician
  • Evansville, IN
  • NPI 1902425812

  Nurse Practitioner

  NPD
• Deaconess Clinic, Inc

  • Rural Health Clinic/Center
  • Petersburg, IN
  • NPI 1831345792

  Nurse Practitioner

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Deaconess Hospital Inc

  • General Acute Care Hospital
  • Newburgh, IN
  • NPI 1780535427
  Care Compare affiliation
• Deaconess Hospital, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1053361642
  Care Compare affiliation

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1891247748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MARY ST",
            "address_2": "STE 520",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101682",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MARY ST STE 520",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101682",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Saint Marys Dr Ste 200E",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477140518",
            "country_code": "US",
            "telephone_number": "812-424-8231 x2283",
            "fax_number": "812-435-8794",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4133 Gateway Blvd Ste 290",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476307918",
            "country_code": "US",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "MANDY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006822A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71006822A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300002641",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000001070519",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100465900",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA STATE LICENSE",
            "identifier": "71006822",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "FULLINGTON",
            "middle_name": "MARIE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrea Wright, LPN
• Georgia Wright
• Haley Wright
• Lauren Nicole Wright, DC
• Linda Wright
• Nathan Wright, DC
• Roberta J Wright, CRT, RCP
• John P Wuertz, MD
• Philip A Wuertz, LCSW
• Peter Wulff, DMD

• Gerontology Nurse Practitioner in Evansville, IN
• Providers in Evansville, IN by specialty
• Gerontology Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.