Individual provider Active NPI

Emily Diane Andrews-Wilkinson, NP

  • Family Nurse Practitioner
  • Brookhaven, MS
National Provider Identifier
1306884259
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R653683 Issued in MS
Practice address
503 Silver Cross Dr
Brookhaven, MS 39601-2388
Phone
(601) 833-2361
NPI assigned
Jun 3, 2006
Last updated
May 19, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R653683 MS Primary
Emergency Medicine Physician 207P00000X R653683 MS

Addresses

Primary practice location

503 Silver Cross Dr
Brookhaven, MS 39601-2388

Mailing address

4109 Highway 98 W
Summit, MS 39666-9132
Phone (601) 276-3900

Other identifiers 1

IdentifierTypeStateIssuer
00125598MedicaidMS

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
I20060626000229 MS Practitioner - Nurse Practitioner 9739191263 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R653683MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lampton Medical Associates, P.a. Family CurrentSince Apr 9, 2022 Accepting new patients
Peak Healthcare Family Past Accepting new patients

Locations

503 Silver Cross Dr
Brookhaven, MS 39601
Phone (601) 833-2353

415 Marion Ave
McComb, MS 39648
Phone (601) 584-8700

501 S Locust St
McComb, MS 39648
Phone (601) 684-8111

Organizations & group practices 2

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242691200000",
    "number": "1306884259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 HIGHWAY 98 W",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396669132",
            "telephone_number": "601-276-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 SILVER CROSS DR",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012388",
            "telephone_number": "601-833-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS-WILKINSON",
        "first_name": "EMILY",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2009-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R653683",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "R653683",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125598",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

Verify at the official NPI Registry.