Individual provider Active NPI

Sanjuana Nicole Gonzalez, FNP-C

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1609576529
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
905873 Issued in MS
Practice address
499 S Gloster St Ste D1
Tupelo, MS 38801-5539
Phone
(662) 690-8007
NPI assigned
Mar 8, 2023
Last updated
May 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 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 905873 MS Primary

Addresses

Primary practice location

499 S Gloster St Ste D1
Tupelo, MS 38801-5539

Mailing address

499 S Gloster St Ste D1
Tupelo, MS 38801-5539
Phone (662) 690-8007

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
I20231114003862 MS Practitioner - Nurse Practitioner 2668829540 Reassigns benefits to 1 organization

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)

499 Gloster Creek VLG
D1
Tupelo, MS 38801-4753
Phone (662) 690-8007

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
905873MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Access Family Health Services, Inc. CurrentSince Oct 7, 2023 Accepting new patients
Access Family Health Services, Inc. Current Accepting new patients
Access Family Health Services, Inc. CurrentSince Oct 7, 2023 Accepting new patients
Northwest Michigan Health Services, Inc. Past Accepting new patients
Access Family Health Services, Inc. Past Accepting new patients

Locations

106 Walker St
Houlka, MS 38850
Phone (662) 568-3316

411 W Main St
Okolona, MS 38860
Phone (662) 447-2918

499 Gloster Creek Vlg
Ste D1
Tupelo, MS 38801
Phone (662) 690-8007

Interoperability endpoints

  • Direct secure messaging: sanjuana.gonzalez.1@14756.direct.athenahealth.com
  • Direct secure messaging: sanjuana.gonzalez.1@20757.direct.athenahealth.com
  • Direct secure messaging: sanjuana.gonzalez.1@29425.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1609576529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 S GLOSTER ST STE D1",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015539",
            "telephone_number": "662-690-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 S GLOSTER ST STE D1",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015539",
            "telephone_number": "662-690-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "SANJUANA",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.