Anna Danielle Woodruff, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R867633 Issued in MS

Practice address

499 Gloster Creek VLG Ste H3
Tupelo, MS 38801-4661

Phone

(662) 840-6026

Fax

(662) 840-6030

NPI assigned

Jan 24, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Anna Danielle Street Former name

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: annawoodruff@nmhs.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Mississippi Medical Center Inc

  • Psychologist
  • Tupelo, MS
  • NPI 1972608347
  Medicare reassignment NPD
• North Mississippi Medcial Center, Inc.

  • Diagnostic Radiology Physician
  • Tupelo, MS
  • NPI 1902762487
  NPD
• North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1376969683
  NPD
• North Mississippi Medical Center, Inc.

  • Neurological Surgery Physician
  • Starkville, MS
  • NPI 1639602014
  NPD
• Ivancic Pediatric Clinic PA

  • Primary Care Clinic/Center
  • Tupelo, MS
  • NPI 1942606256
  NPD (past)
• Pontotoc Health Services, Inc.

  • Critical Access Hospital
  • Pontotoc, MS
  • NPI 1821103516
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1013330299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG STE H3",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014661",
            "telephone_number": "662-840-6026",
            "fax_number": "662-840-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG STE H3",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014661",
            "telephone_number": "662-840-6026",
            "fax_number": "662-840-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "ANNA",
        "middle_name": "DANIELLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-24",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R867633",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R867633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04106368",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "STREET",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Womfroe Homecare LLC
• Alison Wood, OTR/L
• Greg Lynn Wood, RPH
• Haley Jordyn Wood, M.A., BCBA
• Leslie Wood
• Thomas D Wooldridge, MD
• Misty Renae Wooten
• James Mike Wortham, BA
• George Worthen, RPH
• Brenda Elain Worthey, FNP-C

• Nurse Practitioner in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.