NPIMap

Individual provider Active NPI

Amanda Rose Smith, FNP-C

  • Family Nurse Practitioner
  • Monticello, MS
National Provider Identifier
1992324834
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903907 Issued in MS
Practice address
1167 E Broad St
Monticello, MS 39654-7682
Phone
(601) 587-1433
Fax
(601) 587-1625
NPI assigned
Apr 10, 2020
Last updated
Apr 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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 903907 MS Primary

Addresses

Primary practice location

1167 E Broad St
Monticello, MS 39654-7682

Mailing address

PO Box 490
McComb, MS 39649-0490
Phone (601) 250-4366

Other practice location 1

1065 E Broad St
Monticello, MS 39654-7703
Phone (601) 587-4051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200922000056 MS Practitioner - Nurse Practitioner 9335567445 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Mississippi Regional Medical CenterGroup PAC ID 5193633907, shared by 11 NPIs, 82 clinicians

Practice addresses (Care Compare)

200 Marion Ave
McComb, MS 39648-2706
Phone (601) 250-4381

827 F E Sellers Hwy
Monticello Family Practice
Monticello, MS 39654-9378
Phone (601) 587-7405

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as apm
Quality
73.43
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Mississippi Regional Medical Center CurrentSince Oct 1, 2025 Accepting new patients
Southwest Mississippi Regional Medical Center CurrentSince Oct 1, 2020 Accepting new patients
Southwest Mississippi Regional Medical Center CurrentSince Oct 1, 2020 Accepting new patients
Southwest Mississippi Regional Medical Center Current Accepting new patients
Southwest Mississippi Regional Medical Center Past Accepting new patients

Locations

200 Marion Ave
McComb, MS 39648
Phone (601) 250-4381

215 Marion Ave
McComb, MS 39648
Phone (601) 249-1180

1065 E Broad St
Monticello, MS 39654
Phone (601) 249-1350

1167 E Broad St
Monticello, MS 39654
Phone (601) 587-1433

827 F E Sellers Hwy
Monticello, MS 39654
Phone (601) 587-4648

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1992324834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-250-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1167 E BROAD ST",
            "city": "MONTICELLO",
            "state": "MS",
            "postal_code": "396547682",
            "telephone_number": "601-587-1433",
            "fax_number": "601-587-1625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1065 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "MS",
            "postal_code": "396547703",
            "country_code": "US",
            "telephone_number": "601-587-4051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, MS

Sources for this page

Verify at the official NPI Registry.