MRS. MISTY MOORE IVY (C.R.N.P.) – Family Nurse Practitioner, NPI 1063465482
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,566 NURSE PRACTITIONER in MS
Provider Addresses for MRS. MISTY MOORE IVY (C.R.N.P.)
7203 GOODMAN RD
OLIVE BRANCH, MS 386541906
Phone: (901) 759-2322
Type: Location
1350 FORREST LAKE CV
HERNANDO, MS 386327500
Phone: (901) 759-2322
Type: Mailing
7585, Clarington Cove, Southaven, DeSoto County, Mississippi, 38671, United States
SOUTHAVEN, MS 386711516
Phone: (662) 349-0200
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 121 Open Payments records for all available years, with a total value of $2,330.
Total Amount is formed as General ($2,330) + Research ($0) + Ownership ($0) = $2,330.
Last reported payment date: 2024-12-02 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($655).
Total Amount
$2,330
General + Research + Ownership
Payments
121
Total payment records
General Amount
$2,330
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $655 |
| ABBVIE INC. | $456 |
| Regeneron Healthcare Solutions, Inc. | $169 |
| Incyte Corporation | $159 |
| SUN PHARMACEUTICAL INDUSTRIES INC. | $153 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-04-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080327000658 | I | Nurse Practitioner | MS | TBD |
| I20190417000594 | I | Nurse Practitioner | TN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 38654)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | MS | 11101 | Biopsy of each additional growth of skin and/or tissue | 429 | 187 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | TN | |
| Physician Assistant | TN | |
| Physician Assistant | TN | |
| Physician Assistant | TN | |
| Physician Assistant | TN | |
| Nurse Practitioner | TN | |
| Dermatology, Pathology | TN |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.