Individual provider Active NPI

Donna Grisham

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1912771486
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
905951 Issued in MS
Practice address
65 S Thomas St
Tupelo, MS 38801-4352
Phone
(662) 350-7010
Fax
(662) 350-7011
NPI assigned
Nov 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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 905951 MS Primary

Addresses

Primary practice location

65 S Thomas St
Tupelo, MS 38801-4352

Mailing address

PO Box 497
Augusta, AR 72006-0497
Phone (870) 472-5348

Other practice location 1

5482 Highway 15 N
Ecru, MS 38841
Phone (662) 488-8799

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
I20240708001676 MS Practitioner - Nurse Practitioner 5395289987 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
ArcareGroup PAC ID 2567370620, 249 clinicians

Practice addresses (Care Compare)

65 S Thomas St
Tupelo, MS 38801-4352
Phone (662) 350-7010

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
905951MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arcare CurrentSince May 6, 2024 Accepting new patients
Friendship Medical Clinic, LLC CurrentSince Nov 1, 2023 Accepting new patients
Arcare CurrentSince May 6, 2024 Accepting new patients

Locations

5482 Highway 15 N
Ecru, MS 38841
Phone (662) 256-9730

353 Highway 15 N
Pontotoc, MS 38863
Phone (662) 489-5999

65 S Thomas St
Tupelo, MS 38801
Phone (662) 205-4475

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGAACA
  • Direct secure messaging: donna.grisham@arcare.directbygreenway.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1699920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1912771486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 497",
            "city": "AUGUSTA",
            "state": "AR",
            "postal_code": "720060497",
            "telephone_number": "870-472-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 S THOMAS ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014352",
            "telephone_number": "662-350-7010",
            "fax_number": "662-350-7011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5482 Highway 15 N",
            "address_purpose": "LOCATION",
            "city": "Ecru",
            "state": "MS",
            "postal_code": "38841",
            "country_code": "US",
            "telephone_number": "662-488-8799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "DONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-14",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.