PHILLIP MATTHEW EZELL FNP-BC, AGACNP-BC
NPI 1689453524
Family Medicine - Adult Medicine in Petal, MS
About Phillip Matthew Ezell Fnp-bc, Agacnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PHILLIP MATTHEW EZELL FNP-BC, AGACNP-BC (NPI 1689453524) is an individual adult medicine provider in Petal, Mississippi, licensed in Mississippi (905839) and active in the NPI registry since September 2023. He is enrolled in Medicare PECOS, is affiliated with Forrest General Hospital, and maintains a secondary practice location in Hattiesburg.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Phillip Matthew Ezell Fnp-bc, Agacnp-bc 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.
Medicare Billing Reassignment
Medicare enrollment records show Phillip Ezell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Richland, MS 39218
- Reassigned Medicare billing, Mississippi enrollment
- 46 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Forrest General Hospital
Acute Care Hospitals · Hattiesburg, MSPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 39465 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Phillip Ezell's NPI number?
The NPI number for Phillip Ezell is 1689453524. It was assigned to this individual provider in the NPPES registry on September 28, 2023.
Where is Phillip Ezell located?
Phillip Ezell practices at 908 S George Ave, Petal, MS 39465. The listed phone number is (601) 544-7441.
What is Phillip Ezell's specialty?
The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.
Is Phillip Ezell enrolled in Medicare?
Yes. Phillip Ezell 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.
Which organization bills Medicare for Phillip Ezell's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Phillip Ezell reassigns Medicare benefits to Medical Systems Management LLC (Richland, MS). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Phillip Ezell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Phillip Ezell accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee list Phillip Ezell 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 Phillip Ezell affiliated with any hospitals?
According to CMS data, Phillip Ezell is affiliated with Forrest General Hospital.
When was this NPI record last updated?
The NPPES record for Phillip Ezell was last updated on January 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.
# Phillip Matthew Ezell, FNP-BC, AGACNP-BC · NPI 1689453524
Adult Medicine physician in Petal, Mississippi. Individual provider, active in the CMS NPPES registry since September 28, 2023.
## Identity
- **NPI:** 1689453524 (Entity type: Individual)
- **Enumerated:** September 28, 2023
- **Primary specialty:** Family Medicine - Adult Medicine · taxonomy 207QA0505X
- **State license:** 905839 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 908 S GEORGE AVE, Petal, MS 39465-2077
- **Phone:** (601) 544-7441
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Medical Systems Management LLC (NPI 1740555267, Richland, MS), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of South Alabama College Of Medicine, class of 2022
## Record status
- **NPPES last updated:** January 5, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1689453524) · Data from the CMS NPPES public registry.