Individual provider Active NPI

Avery Carpenter, FNP-BC

  • Family Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1952192627
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
905604 Issued in MS
Practice address
23 Cross HL
Hattiesburg, MS 39402-7519
Phone
(601) 606-3456
NPI assigned
May 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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 905604 MS Primary

Addresses

Primary practice location

23 Cross HL
Hattiesburg, MS 39402-7519

Mailing address

6051 U S Highway 49
Hattiesburg, MS 39401-7200

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
I20250812004026 MS Practitioner - Nurse Practitioner 9830697408 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince Jun 16, 2025 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Jun 16, 2025 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

835 Thames Ave
Bay St Louis, MS 39520
Phone (228) 466-4977

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

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": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1952192627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6051 U S HIGHWAY 49",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CROSS HL",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394027519",
            "telephone_number": "601-606-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "AVERY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.