Hollie Dulaney Moffatt, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

904051 Issued in MS

Practice address

315 Magazine St Ste C
Tupelo, MS 38804-4802

Phone

(662) 350-0760

NPI assigned

Aug 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Mississippi Medical Center, Inc.Group PAC ID 9931010600, 361 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pontotoc Health Service Inc Cah Hospital, Pontotoc, MS, CCN 251308

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: holliemoffatt@nmhs.medalliesdirect.net

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.

• North Mississippi Medical Center Inc

  • Psychologist
  • Tupelo, MS
  • NPI 1972608347

  MS

  Medicare reassignment Care Compare group NPD
• Pontotoc Health Services, Inc.

  • Critical Access Hospital
  • Pontotoc, MS
  • NPI 1821103516

  MS

  Medicare reassignment NPD
• Region IV Mental Health Services

  • Community/Behavioral Health Agency
  • Booneville, MS
  • NPI 1699869537

  MS

  Medicare reassignment NPD
• North Mississippi Medical Center Inc.

  • Neurology Physician
  • Tupelo, MS
  • NPI 1417357427
  Care Compare group
• North Mississippi Medical Center Inc.

  • Rural Health Clinic/Center
  • Tupelo, MS
  • NPI 1649727447
  Care Compare group
• North Mississippi Medical Center, Inc.

  • Home Health Agency
  • Tupelo, MS
  • NPI 1003871344
  Care Compare group
• North Mississippi Medical Center, Inc.

  • Skilled Nursing Facility
  • Baldwyn, MS
  • NPI 1164539193
  Care Compare group
• North Mississippi Medical Center, Inc.

  • Psychiatric Hospital Unit
  • Tupelo, MS
  • NPI 1265549646
  Care Compare group
• North Mississippi Medical Center, Inc.

  • Rehabilitation Hospital Unit
  • Tupelo, MS
  • NPI 1326155706
  Care Compare group
• North Mississippi Medical Center, Inc.

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1598875460
  Care Compare group
• North Mississippi Medical Center, Inc.

  • Community Based Hospice Care Agency
  • Tupelo, MS
  • NPI 1982669156
  Care Compare group
• North Mississippi Medcial Center, Inc.

  • Diagnostic Radiology Physician
  • Tupelo, MS
  • NPI 1902762487
  NPD

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

• Pontotoc Health Services, Inc.

  • Critical Access Hospital
  • Pontotoc, MS
  • NPI 1821103516

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1962013664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 N LANE DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014500",
            "telephone_number": "662-871-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MAGAZINE ST STE C",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388044802",
            "telephone_number": "662-350-0760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2664 S Harper Rd",
            "address_purpose": "LOCATION",
            "city": "Corinth",
            "state": "MS",
            "postal_code": "388346723",
            "country_code": "US",
            "telephone_number": "662-287-4055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOFFATT",
        "first_name": "HOLLIE",
        "middle_name": "DULANEY",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "904051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Desktop",
            "affiliation": "N",
            "endpointDescription": "Desktop",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2664 S Harper Rd",
            "city": "Corinth",
            "state": "MS",
            "country_code": "US",
            "postal_code": "388346723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary Ellen Mitchell, MSN,FNP
• Jennifer Stewart Mize, AU.D., CCC-A
• Lori Mize, FNP
• MMSS Ancillary Services Inc
• Pranav Modi, MBBS
• Rayyan Mohammed, DO
• Molecular and Diagnostic Testing Labs of America
• David Monaghan, M.D.
• Michael Monroe, D.M.D.
• Brandon Montgomery, MD

• All providers in Tupelo, MS
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.