Individual provider Active NPI

Brook Leann Ponder, NP

  • Family Nurse Practitioner
  • Ridgeland, MS
National Provider Identifier
1578346755
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906153 Issued in MS
Practice address
1612 E County Line Rd
Ridgeland, MS 39157-1906
Phone
(931) 253-1110
NPI assigned
Aug 14, 2023
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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 906153 MS Primary

Addresses

Primary practice location

1612 E County Line Rd
Ridgeland, MS 39157-1906

Mailing address

1612 E County Line Rd
Ridgeland, MS 39157-1906
Phone (931) 253-1110

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
I20231110000217 MS Practitioner - Nurse Practitioner 6800243957 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

1050 Hwy 98 Byp
Columbia, MS 39429-9190
Phone 93125311108053

1061 Hwy 35 S
Forest, MS 39074-4000
Phone (931) 253-1110

115 Hwy 16 W
Carthage, MS 39051-4240
Phone (931) 253-1110

2059 Hwy 61 N
Vicksburg, MS 39183-8227
Phone (601) 429-1144

2700 N Hills St
Meridian, MS 39305-2641
Phone (601) 685-3010

296 Eastside Dr
Newton, MS 39345-8036
Phone (601) 228-8985

50 Veterans Memorial Dr
Kosciusko, MS 39090-3424
Phone (662) 307-2884

517 City Ave S
Ripley, MS 38663-2517
Phone (662) 587-8206

760 Brookway Blvd
Brookhaven, MS 39601-2658
Phone (423) 662-7002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
906153MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 22, 2025 Accepting new patients
Fast Pace Mississippi, PLLC Family CurrentSince Oct 1, 2023 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 22, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Oct 1, 2023 Accepting new patients
Geriatric Connections, LLC Family CurrentSince Jun 27, 2024 Accepting new patients

Locations

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

360 Simpson Highway 149
Ste 220
Magee, MS 39111
Phone (601) 849-1220

234 Magnolia Dr
Raleigh, MS 39153
Phone (601) 374-8145

1612 E County Line Rd
Ridgeland, MS 39157
Phone (601) 429-1160

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

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": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1578346755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 E COUNTY LINE RD",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571906",
            "telephone_number": "931-253-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 E COUNTY LINE RD",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571906",
            "telephone_number": "931-253-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDER",
        "first_name": "BROOK",
        "middle_name": "LEANN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

Verify at the official NPI Registry.