Wanda Brown, WHNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

901414 Issued in MS

Practice address

4240 Bethel Rd Ste 101
Olive Branch, MS 38654-8737

Phone

(662) 932-9544

Fax

(662) 932-9554

NPI assigned

Jan 19, 2016

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

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Care Group, LLCGroup PAC ID 0941480131, 108 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Primary Care Group LLC

  • Family Medicine Physician
  • Memphis, TN
  • NPI 1093016651

  MS

  Medicare reassignment Care Compare group NPD
• Memphis Primary Care & Wellness Associates

  • Internal Medicine Physician
  • Germantown, TN
  • NPI 1366509721
  NPD (past)

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1083071237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 BETHEL RD STE 101",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548737",
            "telephone_number": "662-932-9544",
            "fax_number": "662-932-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "WANDA",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "901414",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MS",
            "license": "901414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fredricca Jazzman Brock, BCBA
• Brown Family Retina
• Barbara Brown, LPC-MHSP
• Calvin Christopher Brown, M.D.
• Ellison Brown Jr.
• Amy Bryant, RPH
• Karen Denise Buchanan, APRN
• Rena Sharnette Buckkey
• William Budd, PHD
• Ashley Buescher, NURSE PRACTITIONER

• All providers in Olive Branch, MS
• Women's Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.