NPIMap

Organization Active NPI

RH Arise Venture of Tupelo LLC

  • Psychiatry Physician
  • Tupelo, MS
National Provider Identifier
1124776067
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
RH ARISE VENTURE OF TUPELO LLC
Practice address
777 Holly Hill Dr
Tupelo, MS 38801-2340
Phone
(662) 432-1221
NPI assigned
Mar 10, 2022
Last updated
Oct 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Authorized official

Name
Jennifer Kathryn Wakeford
Title
Enterprise Cfo
Phone
(205) 901-5103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

777 Holly Hill Dr
Tupelo, MS 38801-2340

Mailing address

PO Box 7058
Tupelo, MS 38802-7058

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EHR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220607000571 MS Part B Supplier - Clinic/Group Practice 2567840309 Receives reassigned benefits from 12 practitioners
Practice locations: Tupelo, MS

National Provider Directory

National Provider Directory

Locations

111 S Spring St
Fl 2
Tupelo, MS 38804
Phone (662) 432-1221

111 S Spring St
Ste 2
Tupelo, MS 38804

201 W Main St
#2
Tupelo, MS 38804

777 Holly Hill Dr
Tupelo, MS 38801
Phone (662) 432-1221

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760572800000",
    "number": "1124776067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7058",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388027058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HOLLY HILL DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388012340",
            "telephone_number": "662-432-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RH ARISE VENTURE OF TUPELO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-10",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A",
        "authorized_official_last_name": "WAKEFORD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "KATHRYN",
        "authorized_official_title_or_position": "ENTERPRISE CFO",
        "authorized_official_telephone_number": "205-901-5103"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "address_1": "201 W Main St Fl 2",
            "city": "Tupelo",
            "state": "MS",
            "country_code": "US",
            "postal_code": "388043917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.