Individual provider Active NPI

Amanda Cranford, FNP

  • Family Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1962801779
Registry record updated Aug 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R882638 Issued in MS
Practice address
1800 12TH St Ste 1D
Meridian, MS 39301-4158
Phone
(601) 703-9165
NPI assigned
Aug 18, 2014
Last updated
Aug 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2014

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 R882638 MS Primary

Addresses

Primary practice location

1800 12TH St Ste 1D
Meridian, MS 39301-4158

Mailing address

1800 12TH St Ste 1D
Meridian, MS 39301-4158
Phone (601) 703-9165

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
I20141017000540 MS Practitioner - Nurse Practitioner 2466673355 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush Medical FoundationGroup PAC ID 2567368541, shared by 7 NPIs, 31 clinicians

Practice addresses (Care Compare)

603 S Archusa Ave
Ochsner Health Center Quitman
Quitman, MS 39355-2331
Phone (601) 776-2123

605 S Archusa Ave
Quitman, MS 39355-2331
Phone (601) 776-6925

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R882638MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kemper Cah, Inc CurrentSince Jan 7, 2016 Accepting new patients
Kemper Cah, Inc Family CurrentSince Jan 7, 2016 Accepting new patients
Kemper Cah, Inc. Current Accepting new patients
Rush Medical Foundation Current Accepting new patients
Rush Medical Foundation CurrentSince Jan 7, 2016 Accepting new patients
Rush Medical Foundation CurrentSince Jan 7, 2016 Accepting new patients

Locations

14365 Highway 16 W
De Kalb, MS 39328
Phone (769) 486-1000

5334 Dale Dr
Marion, MS 39342
Phone (601) 703-0130

1800 12th St
#1D
Meridian, MS 39301
Phone (601) 703-9541

1800 12th St
Ste 1D
Meridian, MS 39301
Phone (601) 703-9165

603 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-2123

605 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-6925

Organizations & group practices 6

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": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1962801779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 12TH ST STE 1D",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014158",
            "telephone_number": "601-703-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 12TH ST STE 1D",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014158",
            "telephone_number": "601-703-9165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANFORD",
        "first_name": "AMANDA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R882638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.