Individual provider Active NPI

Wilson Ryder Heath

  • Emergency Medicine Physician
  • Jackson, MS
National Provider Identifier
1922702133
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
T-4931 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-1000
NPI assigned
Mar 30, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X T-4931 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5582

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251114001110 MS Practitioner - Emergency Medicine 5991296287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mississippi Physicians LLPGroup PAC ID 7113193855, 24 clinicians
Grenada Emergency Group, LLCGroup PAC ID 2163854225, 37 clinicians
Yazoo Emergency Group, LLCGroup PAC ID 0749511574, 19 clinicians

Practice addresses (Care Compare)

1225 N State St
Jackson, MS 39202-2064
Phone (601) 968-1000

239 Bowling Green Rd
Lexington, MS 39095-5167
Phone (662) 834-1321

823 Grand Ave
Yazoo City, MS 39194-3233
Phone (662) 746-2261

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T-4931MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yazoo Emergency Group, LLC Emergency Medicine CurrentSince Oct 1, 2025 Accepting new patients
Grenada Emergency Group, LLC Emergency Medicine CurrentSince Jan 13, 2026 Accepting new patients

Locations

239 Bowling Green Rd
Lexington, MS 39095
Phone (662) 834-1321

823 Grand Ave
Yazoo City, MS 39194
Phone (601) 746-2261

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 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": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1922702133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATH",
        "first_name": "WILSON",
        "middle_name": "RYDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "T-4931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.