Carly O'Neal, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

902870 Issued in MS

Practice address

2100 E Chambers Dr
Booneville, MS 38829-8938

Phone

(662) 286-9883

NPI assigned

Aug 28, 2018

Last updated

Aug 28, 2018By the provider in NPPES

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

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mantachie Rural Health Care, IncGroup PAC ID 2567372121, shared by 4 NPIs, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Region IV Mental Health Services

  dba Timber Hills Mental Health

  • Community/Behavioral Health Agency
  • Booneville, MS
  • NPI 1699869537
  Medicare reassignment NPD
• Region IV Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Booneville, MS
  • NPI 1487984407
  NPD
• Region IV Mental Health Services

  • Community/Retail Pharmacy
  • Hernando, MS
  • NPI 1689915423
  NPD

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1992286777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 ENGLEWOOD CV",
            "city": "SALTILLO",
            "state": "MS",
            "postal_code": "388668725",
            "telephone_number": "662-397-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E CHAMBERS DR",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388298938",
            "telephone_number": "662-286-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "CARLY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "902870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northeast Mississippi Community Services, Inc..
• Northeast Mississippi Inpatient Services, LLC
• Northeast Mississippi Planning and Development District
• Northeast Mississippi Planning and Development District
• Northeast Ms Internal Medicine PC
• Ortho Express Holding Company, LLC (OrthoXpress Bone & Joint Center of Booneville)
• Austin Brock Parris, DDS
• Karla Pellizzer, LCSW
• Performance Physical Therapy, Inc.
• Felesha Dale Perrigo, FNP

• Psychiatric/Mental Health Nurse Practitioner in Booneville, MS
• Providers in Booneville, 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 28, 2018; 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.