Individual provider Active NPI

Anna Crow Gordon

  • Nurse Practitioner
  • Southaven, MS
National Provider Identifier
1124765656
Registry record updated Sep 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
904651 Issued in MS
Practice address
60 Physicians LN
Southaven, MS 38671-6122
Phone
(769) 243-6141
Fax
(601) 510-1665
NPI assigned
May 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 904651 MS Primary

Addresses

Primary practice location

60 Physicians LN
Southaven, MS 38671-6122

Mailing address

778 Liberty Rd
Flowood, MS 39232-9300
Phone (769) 243-6141

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
I20220920002580 MS Practitioner - Nurse Practitioner 9436534948 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
Wound Management Specialists LLCGroup PAC ID 5193056364, 157 clinicians
Healthcare Plus Limited Liability CompanyGroup PAC ID 5698038610, 120 clinicians

Practice addresses (Care Compare)

1190 N State St
Jackson, MS 39202-2413
Phone (769) 243-6141

2781 C T Switzer Sr Dr
Suite 100
Biloxi, MS 39531-4535
Phone (769) 243-6141

Hospital & facility affiliations

  • Panola Medical Center Hospital, Batesville, MS, CCN 250781
  • North Mississippi Specialty Hospital Long-term care hospital, Batesville, MS, CCN 252014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
904651MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Management Specialists, LLC Nurse Practitioner CurrentSince May 23, 2022 Accepting new patients
Healthcare Plus Limited Liability Company Nurse Practitioner CurrentSince Jul 18, 2023 Accepting new patients
Winston Medical Clinic LLC PastSince May 23, 2022 Accepting new patients

Locations

2781 C T Switzer SR Dr
Ste 100
Biloxi, MS 39531
Phone (228) 207-8632

778 Liberty Rd
Flowood, MS 39232
Phone (601) 914-9620

120 Stone Creek Blvd
Ste 300
Flowood, MS 39232
Phone (769) 239-6141

1190 N State St
Ste 2A
Jackson, MS 39202
Phone (601) 292-4292

60 Physicians Ln
Southaven, MS 38671
Phone (601) 349-0707

Organizations & group practices 3

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 2

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": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759017600000",
    "number": "1124765656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "778 LIBERTY RD",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329300",
            "telephone_number": "769-243-6141",
            "fax_number": "601-510-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 PHYSICIANS LN",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716122",
            "telephone_number": "769-243-6141",
            "fax_number": "601-510-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ANNA",
        "middle_name": "CROW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-16",
        "last_updated": "2025-09-28",
        "certification_date": "2025-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "904651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.