Donna Wedgeworth

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R867812 Issued in MS

Practice address

1 Medical LN Ste B
Forest, MS 39074-4039

Phone

(601) 469-4861

Fax

(601) 469-4828

NPI assigned

Jan 30, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Independent Healthcare Management IncGroup PAC ID 0840197232, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Flowood, MS, CCN 257126
• Accentcare Home Health of Carthage Home health agency, Carthage, MS, CCN 257129
• Mississippi Homecare of Jackson Home health agency, Jackson, MS, CCN 257082
• S E Lackey Memorial Hospital Hospital, Forest, MS, CCN 251300

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: donna.wedgeworth@phspch.eclinicaldirectplus.com

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.

• Independent Healthcare Management, Inc.

  • Critical Access Hospital
  • Forest, MS
  • NPI 1306909734
  Medicare reassignment Care Compare group NPD
• Independent Healthcare Management, Inc,

  • Critical Access Hospital
  • Forest, MS
  • NPI 1649592791
  NPD
• Independent Healthcare Management, Inc.

  • Rural Health Clinic/Center
  • Raleigh, MS
  • NPI 1871272724
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Home Health Care Affiliates of Central Mississippi, LLC

  • Home Health Agency
  • Flowood, MS
  • NPI 1417935578
  Care Compare affiliation
• Independent Healthcare Management, Inc.

  • Critical Access Hospital
  • Forest, MS
  • NPI 1306909734
  Care Compare affiliation
• Mississippi Homecare of Jackson II, LLC

  • Home Health Agency
  • Jackson, MS
  • NPI 1730373275
  Care Compare affiliation
• Sta-Home Health Agency of Carthage, Inc

  • Home Health Agency
  • Carthage, MS
  • NPI 1275674533
  Care Compare affiliation

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1952865214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL LN STE B",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390744039",
            "telephone_number": "601-469-4861",
            "fax_number": "601-469-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL LN STE B",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390744039",
            "telephone_number": "601-469-4861",
            "fax_number": "601-469-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEDGEWORTH",
        "first_name": "DONNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R867812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R867812",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Kathryn Renee Walker, CFNP
• William L Weaver, PTA
• Joshua Dewuan Wheaton
• Roger Douglas Woods, D.M.D.
• Nicholas Braeden Yarbrough, PHARMD

• Family Nurse Practitioner in Forest, MS
• Providers in Forest, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.