Family Care Clinic of Ripley
Organization Active NPI Nurse Practitioner · Ripley, MS
NPI 1043386642 · NPPES record last updated Jun 1, 2011
Key facts
- NPI
- 1043386642
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 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
- Organization subpart
- No
Authorized official
- Name
- Wanda Stroupe
- Title
- Nurse Practitioner
- Phone
- (662) 993-9336
Practitioners 9
-
Brooke Brown, FNP-BC
-
Leah Harris Nabors, RN, FNP-BC
-
Bailey McNeese, MSN, APRN, NP-C
-
Diana Lynn Leonard, APRN FNP-C
-
Shawn Fortenberry Churchill Coy, FNP-BC, PMHNP-BC
-
Paisleigh Gunn, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070118000156 | MS | Part B Supplier - Clinic/Group Practice | 3072514009 |
Receives reassigned benefits from 8 practitioners Practice locations: Ripley, MS |
National Provider Directory
Locations
1007 N Main St
Ripley, MS 38663
Phone (662) 512-0022
1331 City Ave N
Ripley, MS 38663
Phone (662) 993-9336
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03132873 | Medicaid | MS |
Other providers in Ripley, MS
- Kasha Edgeston
- Jody Lynn Edwards
- Charles McCarley Elliott
- Reeca L Elliott
- Teressa Ellzey
- Family Foot Care Clinic Inc
- Family Foot Care Clinic Inc
- Family Nurse Clinic, Inc
- Farrell Family Counseling Center, LLC
- Fast Pace Mississippi, PLLC
All providers in Ripley, MS · Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.