Mrs Misty Moore Ivy, CRNP in Olive Branch, MS

Mrs Misty Moore Ivy, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Olive Branch, Mississippi. Her current practice location is 7203 Goodman Rd, Olive Branch, Mississippi. You can reach out to her office (for appointments etc.) via phone at (901) 759-2322.

Mrs Misty Moore Ivy is licensed to practice in Mississippi (license number R860233) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063465482.

Contact Information

	Mrs Misty Moore Ivy, CRNP
	7203 Goodman Rd, Olive Branch, MS 38654-1906
	(901) 759-2322
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Misty Moore Ivy
Gender	Female
Speciality	Nurse Practitioner - Family
Location	7203 Goodman Rd, Olive Branch, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063465482
Provider Enumeration Date: 05/18/2006
Last Update Date: 06/20/2024

Medicare PECOS Information:

PECOS PAC ID: 8628020799
Enrollment ID: I20080327000658

Medical Identifiers

Medical identifiers for Mrs Misty Moore Ivy such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063465482	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	APN11904 (Tennessee)	Secondary
363LF0000X	Nurse Practitioner - Family	R860233 (Mississippi)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Misty Moore Ivy allows following entities to bill medicare on her behalf.

Entity Name	Advanced Dermatology And Skin Cancer Associates, Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1265604888 PECOS PAC ID: 2163501834 Enrollment ID: O20130408000403

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Misty Moore Ivy is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Misty Moore Ivy, CRNP 1350 Forrest Lake Cv, Hernando, MS 38632-7500 Ph: (901) 759-2322	Mrs Misty Moore Ivy, CRNP 7203 Goodman Rd, Olive Branch, MS 38654-1906 Ph: (901) 759-2322

Reviews and Comments

Nurse Practitioner Nurses in Olive Branch, MS

Carolyn Wong, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4064 Sidlehill Dr, Olive Branch, MS 38654 Phone: 601-842-9006
Brittany Nikita Carper, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6674 Goodman Rd, Olive Branch, MS 38654 Phone: 662-985-7806
Jennifer C Sanders, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5480 Goodman Rd Ste 1, Olive Branch, MS 38654 Phone: 662-874-6507 Fax: 662-932-8197
Wanda Brown, WHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4240 Bethel Rd Ste 101, Olive Branch, MS 38654 Phone: 662-932-9544 Fax: 662-932-9554
Kori Swearengen, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 9075 Sandidge Center Cv, Olive Branch, MS 38654 Phone: 662-895-4949 Fax: 662-895-6776
Queen Mcghee, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4250 Bethel Rd, Olive Branch, MS 38654 Phone: 662-932-9111

Mrs Misty Moore Ivy, CRNP - Medicare Nurse Practitioner in Olive Branch, MS