Stephanie Machelle Douglass, PMHNP-BC in Olive Branch, MS

Stephanie Machelle Douglass, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Olive Branch, Mississippi. She graduated from nursing school in 2014 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Pure Light Psychiatry Llc and her current practice location is 5600 Goodman Rd, Ste B, Olive Branch, Mississippi. You can reach out to her office (for appointments etc.) via phone at (662) 890-7010.

Stephanie Machelle Douglass is licensed to practice in Mississippi (license number R863198) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1386904803.

Contact Information

	Stephanie Machelle Douglass, PMHNP-BC
	5600 Goodman Rd, Ste B, Olive Branch, MS 38654-7002
	(662) 890-7010
	(662) 890-7044

Map and Direction

Provider's Profile

Full Name	Stephanie Machelle Douglass
Gender	Female
Speciality	Nurse Practitioner
Experience	10 Years
Location	5600 Goodman Rd, Olive Branch, Mississippi
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Stephanie Machelle Douglass graduated from nursing school in 2014

NPI Data:

NPI Number: 1386904803
Provider Enumeration Date: 05/17/2012
Last Update Date: 09/28/2020

Medicare PECOS Information:

PECOS PAC ID: 4981960184
Enrollment ID: I20171103000832

Medical Identifiers

Medical identifiers for Stephanie Machelle Douglass such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1386904803	NPI	-	NPPES
08121826	Medicaid	MS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	R863198 (Mississippi)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Pure Light Psychiatry Llc	4789019365	2

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. Stephanie Machelle Douglass allows following entities to bill medicare on her behalf.

Entity Name	Olive Branch Psychiatric Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1306303011 PECOS PAC ID: 6406197169 Enrollment ID: O20190405000373

Entity Name	Pure Light Psychiatry Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1932742988 PECOS PAC ID: 4789019365 Enrollment ID: O20200109001262

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. Stephanie Machelle Douglass 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
Stephanie Machelle Douglass, PMHNP-BC 5600 Goodman Rd, Ste B, Olive Branch, MS 38654-7002 Ph: (662) 890-7010	Stephanie Machelle Douglass, PMHNP-BC 5600 Goodman Rd, Ste B, Olive Branch, MS 38654-7002 Ph: (662) 890-7010

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
Mrs. Misty Moore Ivy, C.R.N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7203 Goodman Rd, Olive Branch, MS 38654 Phone: 901-759-2322
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

Stephanie Machelle Douglass, PMHNP-BC - Medicare Nurse Practitioner in Olive Branch, MS