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MRS. MARY LYDIA HALL AGPCNP
NPI 1902366495
Nurse Practitioner - Adult Health in Brandon, MS

Active since March 21, 2019PECOS Enrolled
501 AVALON WAY STE C, BRANDON, MS 39047(601) 573-7012 Get Directions Write a Review

NPPES record last updated: June 11, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 11, 2019, Mar 21, 2019 (2 updates tracked since 2019).

About Mrs. Mary Lydia Hall Agpcnp NPPES

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

MRS. MARY LYDIA HALL AGPCNP (NPI 1902366495) is an individual adult health provider in Brandon, Mississippi, licensed in Mississippi (903270) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902366495
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameMRS. MARY LYDIA HALLCredential: AGPCNP
Location Address501 AVALON WAY STE CBrandon, MS 39047-7500
Mailing Address911 Cedar Hill DrClinton, MS 39056-3701 · (601) 594-6335
Phone(601) 573-7012
Sole ProprietorYes
Enumeration DateMarch 21, 2019
Last NPPES UpdateJune 11, 20192 updates tracked since enumeration
✔ NPI 1902366495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in MS · 903270
501 AVALON WAY STE C, Brandon, MS 39047
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Mary Lydia Hall Agpcnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Mary Hall reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southern Medical Consultants LLC
4.9 mi
Primary Care
7048 OLD CANTON RD STE 2E
Ridgeland, MS 39157
  • Reassigned Medicare billing, Mississippi enrollment
  • 37 clinicians in this Medicare group
NPI 1215396577 (601) 992-9790
Community Care Health Network LLC
321 mi
Nurse Practitioner
424 CHURCH ST STE 220
Nashville, TN 37219
  • Reassigned Medicare billing, Mississippi enrollment
  • 195 clinicians in this Medicare group
NPI 1619368842 (877) 564-3627

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39047 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.

Other Providers at the Same Location NPPES 7

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

MRS. BRITTANY CHANTRIECE BURAGE FNP-C
Nurse Practitioner (Family)
501 AVALON WAY STE C
BRANDON, MS 39047
Rankin County (601) 573-7012
JASMINE ARLEAN BLANKS NP-C
Nurse Practitioner (Primary Care)
501 AVALON WAY STE C
BRANDON, MS 39047
Rankin County (601) 992-9790
RESOLVE TO RESTORE COUNSELING SERVICES
Counselor (Professional)
501 AVALON WAY STE C
BRANDON, MS 39047
Rankin County (769) 208-5120
CHIQUITA LOVING NP
Nurse Practitioner (Adult Health)
501 AVALON WAY STE C
BRANDON, MS 39047
Rankin County (601) 573-7012
SHENIKA N WASHINGTON APRN
Nurse Practitioner (Family)
501 AVALON WAY STE C
BRANDON, MS 39047
Rankin County (601) 992-9790
HEATHER PHILLIPS SILVERII FNP
Nurse Practitioner
501 AVALON WAY STE C
BRANDON, MS 39047
Rankin County (601) 992-9790
KACY ARD NP
Nurse Practitioner (Psychiatric/Mental Health)
501 AVALON WAY STE C
BRANDON, MS 39047
Rankin County (601) 573-7012

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 Mary Hall's NPI number?

The NPI number for Mary Hall is 1902366495. It was assigned to this individual provider in the NPPES registry on March 21, 2019.

Where is Mary Hall located?

Mary Hall practices at 501 Avalon Way Ste C, Brandon, MS 39047. The listed phone number is (601) 573-7012.

What is Mary Hall's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Mary Hall enrolled in Medicare?

Yes. Mary Hall is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Mary Hall's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Hall reassigns Medicare benefits to 2 organizations: Southern Medical Consultants LLC (Ridgeland, MS) and Community Care Health Network LLC (Nashville, TN). Each 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 Mary Hall's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Hall was last updated on June 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.