Organization Active NPI

Impact Health & Wellness Clinic

  • Family Nurse Practitioner
  • Ridgeland, MS
National Provider Identifier
1851255962
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
IMPACT HEALTH & WELLNESS CLINIC
Practice address
270 Trace Colony Park Dr Ste B
Ridgeland, MS 39157-8810
Phone
(601) 236-1800
NPI assigned
Dec 12, 2025
Last updated
Apr 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Authorized official

Name
Melissa Wheaton, FNPNPI 1629791660
Title
Provider/Owner
Phone
(601) 236-1800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

270 Trace Colony Park Dr Ste B
Ridgeland, MS 39157-8810

Mailing address

39 Trystan Dr
Petal, MS 39465-2806
Phone (601) 236-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260422002396 MS Part B Supplier - Clinic/Group Practice 6507333085 Receives reassigned benefits from 1 practitioner
Practice locations: Petal, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1765497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775520000000",
    "number": "1851255962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 TRYSTAN DR",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394652806",
            "telephone_number": "601-236-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 TRACE COLONY PARK DR STE B",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391578810",
            "telephone_number": "601-236-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT HEALTH & WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-12",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A",
        "authorized_official_last_name": "WHEATON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "601-236-1800",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.