Individual provider Active NPI

Wendi Lee Ann Nopper, NP-C

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1124323175
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R864347 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-2915
NPI assigned
Jan 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R864347 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

219 Allen Dr
Brandon, MS 39047-4617
Phone (601) 829-9711

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20111026000949 MS Practitioner - Nurse Practitioner 9830362458 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revitalize Hydration Therapy LLCGroup PAC ID 5193154128, 8 clinicians

Practice addresses (Care Compare)

885 Liberty Rd
Suite 300
Flowood, MS 39232-9006
Phone (601) 213-0069

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R864347MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 1, 2012 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 1, 2012 Accepting new patients
University Radiation Oncology Consultants, PLLC Past Accepting new patients

Locations

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

1815 Hospital Dr
Jackson, MS 39204
Phone (601) 815-4775

Interoperability endpoints

  • Direct secure messaging: wnopper6475@ummc.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1124323175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 ALLEN DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390474617",
            "telephone_number": "601-829-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOPPER",
        "first_name": "WENDI",
        "middle_name": "LEE ANN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-24",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R864347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.