NPIMap

Organization Active NPI

Family Care Clinic of Ripley

  • Nurse Practitioner
  • Ripley, MS
National Provider Identifier
1043386642
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
FAMILY CARE CLINIC OF RIPLEY
Practice address
1007 N Main St
Ripley, MS 38663-1424
Phone
(662) 993-9336
Fax
(662) 993-9338
NPI assigned
Nov 27, 2006
Last updated
Jun 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Authorized official

Name
Wanda StroupeNPI 1902876238
Title
Nurse Practitioner
Phone
(662) 993-9336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

1007 N Main St
Ripley, MS 38663-1424

Mailing address

PO Box 4027
Tupelo, MS 38803-4027
Phone (662) 993-9336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070118000156 MS Part B Supplier - Clinic/Group Practice 3072514009 Receives reassigned benefits from 8 practitioners
Practice locations: Ripley, MS

National Provider Directory

National Provider Directory

Locations

1331 City Ave N
Ripley, MS 38663
Phone (662) 993-9336

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1043386642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4027",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388034027",
            "telephone_number": "662-993-9336",
            "fax_number": "662-993-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 N MAIN ST",
            "city": "RIPLEY",
            "state": "MS",
            "postal_code": "386631424",
            "telephone_number": "662-993-9336",
            "fax_number": "662-993-9338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE CLINIC OF RIPLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "STROUPE",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "662-993-9336"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ripley, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.