Individual provider Active NPI

Amanda Hester Thomas

  • Psychiatric/Mental Health Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1902031099
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R903178 Issued in MS
Practice address
219 N Church St
Tupelo, MS 38804-3815
Phone
(662) 260-4533
Fax
(662) 260-4576
NPI assigned
May 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R903178 MS Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1-140387 AL
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

219 N Church St
Tupelo, MS 38804-3815

Mailing address

219 N Church St
Tupelo, MS 38804-3815
Phone (662) 205-4058

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
I20201001000022 MS Practitioner - Nurse Practitioner 3577982164 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthy Life Solutions PLLCGroup PAC ID 4486030814, 2 clinicians

Practice addresses (Care Compare)

219 N Church St
Tupelo, MS 38804-3815
Phone (662) 205-4058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-140387ALMDPsychiatric/Mental Health Nurse Practitioner
R903178MSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Right Track Medical Group, Inc CurrentSince Sep 1, 2020 Accepting new patients
Healthy Life Solutions, PLLC CurrentSince Sep 1, 2022 Accepting new patients
Precise Clinical Neuroscience Specialists PastSince Feb 25, 2026 Accepting new patients
Mississippi Center for Advanced Medicine, PC Past Accepting new patients

Locations

1203 Medical Park Dr
Oxford, MS 38655
Phone (662) 513-4399

200 Highway 12 E
Starkville, MS 39759
Phone (662) 498-1900

4428 S Eason Blvd
Ste B
Tupelo, MS 38801

4428 S Eason Blvd
Tupelo, MS 38801
Phone (601) 844-5080

219 N Church St
Tupelo, MS 38804
Phone (662) 205-4058

Organizations & group practices 4

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": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1902031099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 N CHURCH ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388043815",
            "telephone_number": "662-205-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N CHURCH ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388043815",
            "telephone_number": "662-260-4533",
            "fax_number": "662-260-4576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "AMANDA",
        "middle_name": "HESTER",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R903178",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-140387",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.