Amanda Lee Ham, ANP-BC, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

855720 Issued in MS

Practice address

611 Alcorn Dr
Corinth, MS 38834-9321

Phone

(662) 293-1160

Fax

(662) 293-4254

NPI assigned

Mar 2, 2010

Last updated

Aug 29, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Magnolia Regional Behavioral Health ServicesGroup PAC ID 3375820541, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Magnolia Regional Health Center Hospital, Corinth, MS, CCN 250009

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amandaham@magnolia.medalliesdirect.net

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.

• Magnolia Regional Behavioral Health Services

  • Psychiatry Physician
  • Corinth, MS
  • NPI 1033656889
  Medicare reassignment Care Compare group NPD
• Magnolia Cardiovascular and Thoracic Clinic

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Corinth, MS
  • NPI 1023280872
  Medicare reassignment NPD
• Magnolia Regional Health Center

  dba Magnolia Express Care

  • Internal Medicine Physician
  • Corinth, MS
  • NPI 1649721457
  Medicare reassignment NPD
• Magnolia Regional Health Center

  • General Acute Care Hospital
  • Corinth, MS
  • NPI 1699756445
  NPD
• North Point Cardiovascular and Thoracic Surgery Clinic

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Corinth, MS
  • NPI 1356534622
  NPD (past)

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

• Magnolia Regional Health Center

  • General Acute Care Hospital
  • Corinth, MS
  • NPI 1699756445
  Care Compare affiliation

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1912220237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 GANN ST",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521337",
            "telephone_number": "662-279-0631",
            "fax_number": "662-293-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349321",
            "telephone_number": "662-293-1160",
            "fax_number": "662-293-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAM",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "ANP-BC, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-02",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "R855720",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "855720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07200316",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gunn Drug Co Inc.
• Kayla Gunn
• Valerie Gunther
• Conor Haas, DO
• Tereda Sherell Hairston, CMHT
• Amber Hamm, FNP-C
• Samuel Alexander Hampton, MD
• Hanger Prosthetics & Orthotics Inc
• Marta Elsa Hans, M.D.
• Osvaldo Hans

• Psychiatric/Mental Health Nurse Practitioner in Corinth, MS
• Providers in Corinth, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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.