Amanda Rose Smith, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Monticello, MS
NPI 1992324834 · NPPES record last updated Apr 8, 2026
Key facts
- NPI
- 1992324834
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 903907 (MS)
- Practice address
- 1167 E Broad St
Monticello, MS 39654-7682 - Phone
- (601) 587-1433
- Fax
- (601) 587-1625
- NPI assigned
- Apr 10, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southwest Mississippi Regional Medical Center
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
- St Luke Home Health Services
- Deaconess Homecare- Region I
- Lawrence County Hospital Cah
- King'S Daughters Medical Center-Brookhaven
- Mississippi Baptist Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.09 of 100
- Quality
- 73.43
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200922000056 | MS | Practitioner - Nurse Practitioner | 9335567445 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Mississippi Regional Medical Center | Current |
Accepting new patients | |
| Southwest Mississippi Regional Medical Center | Current |
Accepting new patients | |
| Southwest Mississippi Regional Medical Center | Current | Accepting new patients | |
| Southwest Mississippi Regional Medical Center | Current |
Accepting new patients | |
| Southwest Ms 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
827 F E Sellers Hwy
Monticello, MS 39654
Phone (601) 587-4648
1167 E Broad St
Monticello, MS 39654
Phone (601) 587-1433
1065 E Broad St
Monticello, MS 39654
Phone (601) 249-1350
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 903907 | MS | Yes |
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
Other providers in Monticello, MS
- David Warren Ready
- Rest Well Sleep Diagnostics, LLC
- Sacred Hearts Home Care LLC
- Molly Grace Ready Sasser
- Sherry Chance Pippen, DMD, PA
- Austin Smith
- Shannon Smith
- South Mississippi Medical Supply and Veterans Serivces, LLC
- Southwest Mississippi Planning and Development District
- Southwest Mississippi Regional Medical Center
All providers in Monticello, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.