Individual provider Active NPI

Megan M Wissing, NP

  • Family Nurse Practitioner
  • Bay St Louis, MS
National Provider Identifier
1366024713
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904596 Issued in MS
Practice address
202C Drinkwater Rd
Bay St Louis, MS 39520-1638
Phone
(228) 678-1211
NPI assigned
Apr 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 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 904596 MS Primary

Addresses

Primary practice location

202C Drinkwater Rd
Bay St Louis, MS 39520-1638

Mailing address

202C Drinkwater Rd
Bay St Louis, MS 39520-1638
Phone (228) 678-1211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20220107000035 LA Practitioner - Nurse Practitioner 2163813825 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
904596MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pervez Mussarat MD PMC CurrentSince Feb 8, 2023 Accepting new patients
SDL Medical Services, LLC CurrentSince Apr 15, 2023 Accepting new patients

Locations

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

106 Smart Pl
Slidell, LA 70458
Phone (504) 486-5353

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1366024713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202C DRINKWATER RD",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395201638",
            "telephone_number": "228-678-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202C DRINKWATER RD",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395201638",
            "telephone_number": "228-678-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSING",
        "first_name": "MEGAN",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay St Louis, MS

Sources for this page

Verify at the official NPI Registry.