Individual provider Active NPI

Brenda Lee Brandon, FNP-BC

  • Family Nurse Practitioner
  • Eupora, MS
National Provider Identifier
1124764279
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
905233 Issued in MS
Practice address
156 E Walnut Ave
Eupora, MS 39744-2027
Phone
(662) 258-8293
NPI assigned
May 11, 2022
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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 905233 MS Primary

Addresses

Primary practice location

156 E Walnut Ave
Eupora, MS 39744-2027

Mailing address

115 Springer Ave
Nettleton, MS 38858-6098
Phone (662) 305-5592

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
I20230501003071 MS Practitioner - Nurse Practitioner 8921463753 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians

Practice addresses (Care Compare)

156 E Walnut Ave
Eupora, MS 39744-2027
Phone (731) 394-1145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Mississippi, PLLC Family CurrentSince Apr 1, 2023 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Apr 1, 2023 Accepting new patients
Ultra Health LLC CurrentSince Oct 10, 2025 Accepting new patients
Plantersville Clinic, Inc Family CurrentSince Nov 8, 2025 Accepting new patients

Locations

156 E Walnut Ave
Eupora, MS 39744
Phone (662) 258-8293

602 Craft St
Holly Springs, MS 38635
Phone (662) 333-8070

1220 E Northside Dr
Ste 170
Jackson, MS 39211
Phone (601) 613-6268

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

Interoperability endpoints

  • Direct secure messaging: brenda.brandon.1@29103.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1124764279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 SPRINGER AVE",
            "city": "NETTLETON",
            "state": "MS",
            "postal_code": "388586098",
            "telephone_number": "662-305-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 E WALNUT AVE",
            "city": "EUPORA",
            "state": "MS",
            "postal_code": "397442027",
            "telephone_number": "662-258-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "BRENDA",
        "middle_name": "LEE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eupora, MS

Sources for this page

Verify at the official NPI Registry.