MANIVANH A PRUDHOMME MSN, FNP-BC, AGACNP-
NPI 1144831140
Nurse Practitioner - Family in Vicksburg, MS

Q: What is Manivanh Prudhomme's NPI number?

The NPI number for Manivanh Prudhomme is 1144831140. It was assigned to this individual provider in the NPPES registry on August 12, 2020.

Q: What is Manivanh Prudhomme's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since August 12, 2020PECOS EnrolledAccepts Medicare Assignment

88.44/100

CMS Quality Rating

2011 HIGHWAY 61 N, VICKSBURG, MS 39183(014) 562-2776(601) 456-2622 Get Directions Write a Review

NPPES record last updated: July 13, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 13, 2021, May 24, 2021, Aug 12, 2020 (3 updates tracked since 2020).

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About Manivanh A Prudhomme Msn, Fnp-bc, Agacnp- NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MANIVANH A PRUDHOMME MSN, FNP-BC, AGACNP- (NPI 1144831140) is an individual family provider in Vicksburg, Mississippi, licensed in Mississippi (904068) and active in the NPI registry since August 2020. She is enrolled in Medicare PECOS, is affiliated with Merit Health River Region, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1144831140

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMANIVANH A PRUDHOMMECredential: MSN, FNP-BC, AGACNP-

Location Address2011 HIGHWAY 61 NVicksburg, MS 39183-3918

Mailing Address2011 Highway 61 NVicksburg, MS 39183 · (601) 456-2277 · Fax (601) 456-2622

Phone(014) 562-2776

Fax(601) 456-2622

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateAugust 12, 2020

Last NPPES UpdateJuly 13, 20213 updates tracked since enumeration

NPPES CertifiedJuly 13, 2021

✔ NPI 1144831140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MS · 904068

2011 HIGHWAY 61 N, Vicksburg, MS 39183

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Manivanh A Prudhomme Msn, Fnp-bc, Agacnp- is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648690842

PECOS Enrollment IDI20201008002132

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 19

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

360 services83 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

309 services62 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

230 services178 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

169 services128 patients

Detection test by immunoassay technique for influenza virus 87400

An immunoassay test for influenza virus is a procedure that identifies the presence of the flu virus in your body. It uses your body's immune response to detect specific proteins (antigens) associated with the virus. This helps in early and accurate diagnosis of influenza.

134 services65 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

87 services82 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

60 services54 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

59 services48 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

55 services20 patients

Injection, ketorolac tromethamine, per 15 mg J1885

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

44 services16 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

37 services37 patients

Manual urinalysis test with examination using microscope, automated 81001

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

35 services28 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

29 services29 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

26 services25 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

23 services23 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

20 services18 patients

Detection test by immunoassay technique for streptococcus, group a (strep) 87430

A detection test using the immunoassay technique for Group A Strep is a simple procedure. It identifies a specific bacteria, Streptococcus, which can cause throat infections. A swab from your throat is taken and tested for the presence of these bacteria.

15 services15 patients

Detection test by nucleic acid for multiple types influenza virus 87502

A detection test by nucleic acid for multiple types of influenza virus is a diagnostic procedure. It identifies the genetic material of the virus in your body. It's highly accurate and can distinguish between different flu strains, helping in prompt and precise treatment.

15 services15 patients

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Merit Health River Region

Acute Care Hospitals · Vicksburg, MS

2/5 CMS rating

OwnershipProprietary

CMS Certification Number250031

Location2100 Hwy 61 NVicksburg, MS 39183 · Warren County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39183 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

88.44/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

75.29

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JON BANTUGAN OD

Optometrist

2011 HIGHWAY 61 N
VICKSBURG, MS 39183

Warren County (601) 630-9199

DR. HILARY MELBY PARRISH O.D.

Optometrist

2011 HIGHWAY 61 N
VICKSBURG, MS 39183

Warren County (601) 630-9199

RIVERBEND EYECARE, P.A.

Optometrist

2011 HIGHWAY 61 N
VICKSBURG, MS 39183

Warren County (601) 630-9199

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Manivanh Prudhomme's NPI number?

The NPI number for Manivanh Prudhomme is 1144831140. It was assigned to this individual provider in the NPPES registry on August 12, 2020.

Where is Manivanh Prudhomme located?

Manivanh Prudhomme practices at 2011 Highway 61 N, Vicksburg, MS 39183. The listed phone number is (014) 562-2776.

What is Manivanh Prudhomme's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Manivanh Prudhomme enrolled in Medicare?

Yes. Manivanh Prudhomme is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Manivanh Prudhomme accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list Manivanh Prudhomme as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Manivanh Prudhomme affiliated with any hospitals?

According to CMS data, Manivanh Prudhomme is affiliated with Merit Health River Region.

When was this NPI record last updated?

The NPPES record for Manivanh Prudhomme was last updated on July 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.