Individual provider Active NPI

Christina Treppendahl, FNP-BC

  • Nurse Practitioner
  • Ridgeland, MS
National Provider Identifier
1922273499
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R858785 Issued in MS
Practice address
1000 Highland Colony Pkwy
Suite 7205
Ridgeland, MS 39157-2073
Phone
(601) 366-0855
NPI assigned
Apr 25, 2008
Last updated
Jun 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R858785 MS Primary

Addresses

Primary practice location

1000 Highland Colony Pkwy
Suite 7205
Ridgeland, MS 39157-2073

Mailing address

PO Box 2746
Madison, MS 39130-2746
Phone (601) 366-0855

Other identifiers 1

IdentifierTypeStateIssuer
0121253MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230421000080 FL Practitioner - Nurse Practitioner 4880731850

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R858785MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mitchell Myers, M.D. Past Accepting new patients
Mississippi Em-I Medical Services PC Nurse Practitioner Past Accepting new patients

Organizations & group practices 4

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": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1922273499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2746",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391302746",
            "telephone_number": "601-366-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HIGHLAND COLONY PKWY",
            "address_2": "SUITE 7205",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572073",
            "telephone_number": "601-366-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREPPENDAHL",
        "first_name": "CHRISTINA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R858785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0121253",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

Verify at the official NPI Registry.