Individual provider Active NPI

Anna Gatewood, FNP

  • Family Nurse Practitioner
  • Ridgeland, MS
National Provider Identifier
1770389744
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906997 Issued in MS
Practice address
11 Professional Pkwy
Ridgeland, MS 39157-4114
Phone
(601) 856-2460
NPI assigned
Feb 20, 2025
Last updated
Feb 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 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 906997 MS Primary

Addresses

Primary practice location

11 Professional Pkwy
Ridgeland, MS 39157-4114

Mailing address

143 Church Rd
Brandon, MS 39047-7346

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
I20251119000171 MS Practitioner - Nurse Practitioner 4082105952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Mississippi School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indira IncGroup PAC ID 2668543349, 5 clinicians

Practice addresses (Care Compare)

11 Professional Pkwy
Ridgeland, MS 39157-4114
Phone (601) 856-2460

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
906997MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wesley Dee Granger, M.D., P.a. CurrentSince Feb 23, 2025 Accepting new patients
Indira Inc CurrentSince Oct 1, 2025 Accepting new patients

Locations

11 Professional Pkwy
Ridgeland, MS 39157
Phone (601) 856-2460

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.

Hospital & facility affiliations 4

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": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1770389744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 CHURCH RD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 PROFESSIONAL PKWY",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574114",
            "telephone_number": "601-856-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATEWOOD",
        "first_name": "ANNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

Verify at the official NPI Registry.