Mooneyham Properties

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

MS845026 Issued in MS

Legal business name

MOONEYHAM PROPERTIES

Practice address

1127 Old Fannin Rd
C
Brandon, MS 39047-9265

Phone

(601) 214-4420

NPI assigned

Mar 31, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Wedgeworth Mooneyham, FNP-BCNPI 1134349913

Title

Provider/Owner

Phone

(601) 214-4420

Specialties & licenses 1

Addresses

Other names 1

• 4 the Family Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Wedgeworth Mooneyham, FNP-BC

  • Nurse Practitioner
  • Brandon, MS
  • NPI 1134349913
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301529600000",
    "number": "1184913014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 OLD FANNIN RD",
            "address_2": "C",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390479265",
            "telephone_number": "601-214-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 OLD FANNIN RD",
            "address_2": "C",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390479265",
            "telephone_number": "601-214-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONEYHAM PROPERTIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-31",
        "last_updated": "2011-03-31",
        "status": "A",
        "authorized_official_last_name": "MOONEYHAM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "WEDGEWORTH",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "601-214-4420",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "license": "MS845026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4 the Family Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Frances H Mobley, LCSW
• Malori Michelle Molaison, BA
• Melissa Monaghan, M.A., CCC-SLP
• Christina Louise Montgomery
• Edmund Warren Montgomery III, D.D.S.
• Jennifer Wedgeworth Mooneyham, FNP-BC
• Dorothy Ann Moore
• Dylan Moore
• Hannah Farris Moore, DPT
• Kiana Moore

• Clinic/Center in Brandon, MS
• Providers in Brandon, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.