Individual provider Active NPI

Jody Marie Witherspoon, FNP-C

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1205698008
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906459 Issued in MS
Practice address
124 Garden LN
Tupelo, MS 38804-9221
Phone
(662) 687-3306
NPI assigned
Jan 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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 906459 MS Primary

Addresses

Primary practice location

124 Garden LN
Tupelo, MS 38804-9221

Mailing address

124 Garden LN
Tupelo, MS 38804-9221
Phone (662) 687-3306

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
I20240321000595 MS Practitioner - Nurse Practitioner 7517304926 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

830 S Gloster St
Tupelo, MS 38801-4934
Phone (662) 377-4054

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medcial Center, Inc. CurrentSince Mar 7, 2024 Accepting new patients
North Mississippi Medical Center, Inc. CurrentSince Mar 7, 2024 Accepting new patients
Truhealth, LLC CurrentSince Apr 15, 2024 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
Amory Surgery Clinic, PLLC Past Accepting new patients

Locations

1315 Highway 4 E
Holly Springs, MS 38635
Phone (662) 252-1141

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

4381 S Eason Blvd
Ste 101
Tupelo, MS 38801
Phone (662) 377-4054

925 Calhoun Ave
Yazoo City, MS 39194
Phone (662) 746-6651

1971 Tennessee Ave N
Parsons, TN 38363
Phone (731) 614-1424

Interoperability endpoints

  • Direct secure messaging: jodywitherspoon@nmhs.medalliesdirect.net

Organizations & group practices 6

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": "1706227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1205698008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 GARDEN LN",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388049221",
            "telephone_number": "662-687-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 GARDEN LN",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388049221",
            "telephone_number": "662-687-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERSPOON",
        "first_name": "JODY",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-26",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.