Active NPI 1902876238 Individual Practitioner Female Practitioner

Wanda Sue Stroupe , NP

Nurse Practitioner • Ripley, MS

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Wanda Stroupe, NP is a certified Nurse Practitioner practicing in Ripley, MS. With approximately 23 years of clinical experience since completing medical education in 2003, Wanda Stroupe delivers high-quality medical care to the local community at 1007 N MAIN ST.

Wanda Stroupe is affiliated with Family Care Clinic Of Ripley and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, methylprednisolone acetate, 1 mg, established patient outpatient office visit, visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1007 N Main St

Ripley, MS 386631424

Telephone 6629939336

Fax 6629939338

Associated Practice Facility / Clinic

🏢 Family Care Clinic Of Ripley Facility NPI 1043386642

Medicare Profile & Education

Medical School

Other

Graduation Year

2003

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Ripley, MS

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

23 Yrs +8.3 yrs vs City Avg

City Avg: 14.7 Yrs

State Avg: 11.5 Yrs

Regional Practice Density

4 Specialists

Practicing in Ripley, MS (1098 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

46.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Stroupe (23 Years) 23 Yrs

Ripley Specialty Average (14.7 Years) 14.7 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1010 Injection, methylprednisolone acetate, 1 mg	880	16	$1.00	$0.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	483	120	$140.00	$97.52
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	166	74	$30.00	$12.78
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	147	88	$30.00	$7.54
36415 Insertion of needle into vein for collection of blood sample	140	85	$9.00	$8.42
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	110	38	$43.00	$19.49
83036 Hemoglobin A1C level	100	39	$41.00	$9.32
99497 Advance care planning, first 30 minutes	76	75	$104.00	$63.87
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	67	67	$43.00	$19.39
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	66	66	$159.00	$99.63
G0444 Annual depression screening, 5 to 15 minutes	65	65	$28.00	$14.14
J1100 Injection, dexamethasone sodium phosphate, 1 mg	60	12	$2.00	$0.12
82962 Blood glucose (sugar) test performed by hand-held instrument	49	25	$14.00	$3.21
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	45	32	$35.00	$10.73
81003 Automated urinalysis test	41	31	$12.00	$2.13
G0008 Administration of influenza virus vaccine	36	36	$14.00	$13.72
90653 Vaccine for influenza for injection into muscle	31	31	$120.00	$81.82
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	19	18	$84.00	$31.86
87502 Detection test by nucleic acid for multiple types influenza virus	17	16	$182.00	$85.47
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	13	12	$188.00	$139.16
71046 X-ray of chest, 2 views	12	11	$86.00	$24.75
J1040 Injection, methylprednisolone acetate, 80 mg	12	12	$25.00	$9.71
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	11	11	$42.00	$16.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,100	214	$140.00	$100.03
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	320	162	$30.00	$7.61
36415 Insertion of needle into vein for collection of blood sample	257	152	$9.00	$8.40
J1100 Injection, dexamethasone sodium phosphate, 1 mg	220	37	$2.00	$0.12
83036 Hemoglobin A1C level	187	80	$41.00	$9.41
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	178	95	$35.00	$10.96
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	117	79	$84.00	$34.62
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	116	116	$159.00	$100.89
87502 Detection test by nucleic acid for multiple types influenza virus	114	80	$182.00	$93.88
99497 Advance care planning, first 30 minutes	114	113	$104.00	$66.05
81003 Automated urinalysis test	112	80	$12.00	$2.17
G0444 Annual depression screening, 5 to 15 minutes	112	112	$28.00	$14.19
82962 Blood glucose (sugar) test performed by hand-held instrument	106	61	$14.00	$3.17
99213 Established patient office or other outpatient visit, typically 15 minutes	98	67	$96.00	$70.77
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	89	41	$43.00	$20.38
G0008 Administration of influenza virus vaccine	80	80	$14.00	$13.72
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	69	69	$65.00	$63.70
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	65	51	$42.00	$16.20
J1030 Injection, methylprednisolone acetate, 40 mg	54	40	$15.00	$7.95
J1885 Injection, ketorolac tromethamine, per 15 mg	54	24	$8.00	$0.55
71046 X-ray of chest, 2 views	45	30	$86.00	$25.54
J1040 Injection, methylprednisolone acetate, 80 mg	34	25	$25.00	$11.15
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	28	28	$43.00	$20.63
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	18	18	$215.00	$131.18
93000 Routine ekg using at least 12 leads including interpretation and report	16	14	$61.00	$11.18
73630 X-ray of foot, minimum of 3 views	14	12	$69.00	$25.82
99496 Transitional care management services for problem of high complexity	14	12	$280.00	$216.17
73130 X-ray of hand, minimum of 3 views	13	11	$69.00	$27.77
73560 X-ray of knee, 1-2 views	11	11	$69.00	$25.77

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	556	188	$138.19	$100.07
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	147	106	$30.00	$7.52
83036 Hemoglobin A1C level	108	57	$41.00	$9.09
36415 Insertion of needle into vein for collection of blood sample	104	75	$9.00	$2.90
99497 Advance care planning, first 30 minutes	83	83	$100.87	$67.77
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	76	76	$144.50	$103.50
J1100 Injection, dexamethasone sodium phosphate, 1 mg	76	17	$2.00	$0.12
G0444 Annual depression screening, 5 to 15 minutes	71	71	$25.72	$14.19
81003 Automated urinalysis test	66	51	$12.00	$2.15
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	65	65	$65.00	$63.70
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	63	49	$35.00	$11.16
G0008 Administration of influenza virus vaccine	63	62	$14.00	$13.74
87502 Detection test by nucleic acid for multiple types influenza virus	51	41	$197.29	$92.86
82962 Blood glucose (sugar) test performed by hand-held instrument	48	38	$14.00	$3.13
99213 Established patient office or other outpatient visit, typically 15 minutes	42	33	$93.71	$71.43
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	33	27	$84.00	$41.43
87635 Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen	25	22	$77.28	$49.13
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	24	20	$35.21	$20.97
J1030 Injection, methylprednisolone acetate, 40 mg	22	17	$10.86	$6.66
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	20	16	$42.00	$16.26
71046 X-ray of chest, 2 views	18	14	$86.00	$24.90
90471 Administration of 1 vaccine	14	14	$35.00	$12.86
J1040 Injection, methylprednisolone acetate, 80 mg	12	11	$25.00	$11.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	443	141	$125.00	$101.15
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	141	87	$30.00	$7.67
0011A Adm sarscov2 100mcg/0.5ml1st	101	98	$50.00	$35.87
83036 Hemoglobin A1C level	99	41	$41.00	$9.40
36415 Insertion of needle into vein for collection of blood sample	78	61	$9.00	$2.97
99497 Advance care planning, first 30 minutes	61	61	$100.00	$67.96
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	58	14	$88.00	$32.12
0012A Adm sarscov2 100mcg/0.5ml2nd	58	58	$50.00	$35.87
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	55	55	$140.00	$103.98
81003 Automated urinalysis test	55	37	$12.00	$2.23
82962 Blood glucose (sugar) test performed by hand-held instrument	53	36	$14.00	$3.18
G0444 Annual depression screening, 5 to 15 minutes	51	51	$25.00	$14.28
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	40	23	$35.00	$10.98
99213 Established patient office or other outpatient visit, typically 15 minutes	37	30	$84.00	$70.24
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	32	32	$65.00	$65.00
G0008 Administration of influenza virus vaccine	27	27	$14.00	$13.48
90471 Administration of 1 vaccine	25	25	$35.00	$12.98
71046 X-ray of chest, 2 views	22	16	$86.00	$25.41
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	18	18	$25.00	$19.34
87635 Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen	17	17	$60.00	$48.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	369	113	$125.00	$85.00
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	127	82	$30.00	$7.60
83036 Hemoglobin A1C level	115	45	$41.00	$9.52
36415 Insertion of needle into vein for collection of blood sample	113	75	$9.00	$2.96
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	61	61	$140.00	$88.03
99497 Advance care planning, first 30 minutes	61	58	$100.00	$66.56
99213 Established patient office or other outpatient visit, typically 15 minutes	54	45	$84.00	$57.95
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	52	15	$88.00	$32.87
G0008 Administration of influenza virus vaccine	50	50	$14.00	$14.00
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	49	20	$35.00	$11.11
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	45	45	$25.00	$19.58
G0444 Annual depression screening, 5 to 15 minutes	44	44	$25.00	$13.79
81003 Automated urinalysis test	40	32	$12.00	$2.24
82962 Blood glucose (sugar) test performed by hand-held instrument	36	25	$14.00	$3.25
71046 X-ray of chest, 2 views	31	21	$86.00	$24.01
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	24	18	$179.00	$115.28
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	18	18	$40.00	$20.97
G0009 Administration of pneumococcal vaccine	14	14	$23.00	$15.28
93000 Routine ekg using at least 12 leads including interpretation and report	13	12	$61.00	$13.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	415	149	$125.00	$83.58
36415 Insertion of needle into vein for collection of blood sample	179	113	$9.00	$2.89
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	122	94	$30.00	$8.36
83036 Hemoglobin A1C level	110	54	$41.00	$10.13
81003 Automated urinalysis test	71	47	$12.00	$2.38
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	68	68	$140.00	$90.02
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	68	31	$35.00	$12.89
99497 Advance care planning, first 30 minutes	65	65	$100.00	$68.06
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	51	51	$25.00	$17.92
G0008 Administration of influenza virus vaccine	51	51	$14.00	$13.18
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	47	23	$88.00	$32.89
G0444 Annual depression screening, 5 to 15 minutes	47	47	$25.00	$13.77
82962 Blood glucose (sugar) test performed by hand-held instrument	43	33	$14.00	$3.08
J1030 Injection, methylprednisolone acetate, 40 mg	34	22	$8.00	$6.21
99213 Established patient office or other outpatient visit, typically 15 minutes	34	26	$84.00	$58.31
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	24	24	$40.00	$20.06
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	20	17	$179.00	$114.87
G0009 Administration of pneumococcal vaccine	18	18	$23.00	$14.20
71046 X-ray of chest, 2 views	13	11	$86.00	$22.51
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	12	12	$100.00	$89.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	649	204	$125.00	$80.55
36415 Insertion of needle into vein for collection of blood sample	240	145	$9.00	$2.81
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	217	138	$30.00	$9.13
83036 Hemoglobin A1C level	158	67	$41.00	$11.22
81003 Automated urinalysis test	116	68	$12.00	$2.58
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	112	63	$35.00	$15.13
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	92	92	$140.00	$85.78
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	88	88	$40.00	$20.12
82962 Blood glucose (sugar) test performed by hand-held instrument	88	60	$14.00	$2.99
99213 Established patient office or other outpatient visit, typically 15 minutes	81	66	$84.00	$56.30
99497 Advance care planning, first 30 minutes	76	75	$100.00	$66.10
G0008 Administration of influenza virus vaccine	75	75	$14.00	$12.99
J1030 Injection, methylprednisolone acetate, 40 mg	66	35	$8.00	$6.42
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	63	30	$88.00	$32.45
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	48	48	$25.00	$17.48
G0444 Annual depression screening, 5 to 15 minutes	46	46	$25.00	$13.86
G0009 Administration of pneumococcal vaccine	40	40	$23.00	$17.02
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	36	17	$15.00	$7.01
71046 X-ray of chest, 2 views	34	29	$86.00	$22.13
87804 Detection test by immunoassay with direct visual observation for influenza virus	30	15	$43.00	$14.63
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	25	21	$179.00	$109.10
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	25	25	$19.00	$16.78
93000 Routine ekg using at least 12 leads including interpretation and report	22	19	$61.00	$12.67
90670 Pneumococcal vaccine for injection into muscle	22	22	$220.00	$181.07
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	18	18	$100.00	$92.56
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$192.00	$121.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	793	219	$120.56	$80.57
36415 Insertion of needle into vein for collection of blood sample	244	146	$9.00	$2.76
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	238	160	$30.00	$10.20
83036 Hemoglobin A1C level	182	72	$38.53	$12.51
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	170	90	$34.54	$18.95
82962 Blood glucose (sugar) test performed by hand-held instrument	145	87	$14.00	$3.06
81003 Automated urinalysis test	138	96	$12.00	$2.98
99497 Advance care planning, first 30 minutes	101	101	$100.00	$63.69
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	100	100	$131.32	$86.44
G0444 Annual depression screening, 5 to 15 minutes	91	91	$25.00	$13.52
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	88	37	$13.36	$6.45
J1030 Injection, methylprednisolone acetate, 40 mg	83	48	$8.00	$5.37
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	82	82	$40.00	$19.94
87804 Detection test by immunoassay with direct visual observation for influenza virus	60	26	$43.00	$15.70
99213 Established patient office or other outpatient visit, typically 15 minutes	56	44	$81.43	$56.36
G0008 Administration of influenza virus vaccine	55	55	$14.00	$12.97
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	55	55	$19.00	$16.53
G0009 Administration of pneumococcal vaccine	53	51	$19.57	$17.90
71020 X-ray of chest, 2 views, front and side	50	40	$75.08	$20.18
90670 Pneumococcal vaccine for injection into muscle	48	47	$202.50	$177.85
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	37	31	$167.76	$113.16
93000 Routine ekg using at least 12 leads including interpretation and report	28	27	$57.57	$13.02
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	23	14	$88.00	$32.95
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$178.67	$128.24
73560 X-ray of knee, 1-2 views	12	11	$63.75	$23.09
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	11	11	$15.00	$12.11

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License MS R622214

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

01682365 (MS)

Hospital & Practice Group Affiliations

Family Care Clinic Of Ripley

1331 City Ave N, Ripley, MS 386631102

Phone: 6629939336

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners

Shereda Saint , NP-C

Nurse Practitioner - Family

NPI 1225547185

Nurse Practitioner (Certified)

Whitney Walker , FNP

Nurse Practitioner - Family

NPI 1245638642

Family Nurse Practitioner

Destiny Price , FNP-BC

Nurse Practitioner

NPI 1245902279

Family Nurse Practitioner (Board Certified)

Diana Leonard , APRN FNP-C

Nurse Practitioner - Family

NPI 1538836218

APRNFNPC

Brooke Brown , FNP-BC

Nurse Practitioner - Family

NPI 1871479683

Family Nurse Practitioner (Board Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Business Mailing Address July 08, 2007

Registered at PO BOX 4027, TUPELO, MS 388034027 (Tel: 6623774685)

📍

Updated Practice Location July 08, 2007

Registered at 1007 N MAIN ST, RIPLEY, MS 386631424 (Tel: 6629939336)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as WANDA STROUPE, NP

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Nurse Practitioner (License #R622214 in MS)

🟢

Initial NPI Registration & Enumeration January 26, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1902876238

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: January 26, 2006

Last Update: July 08, 2007

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 4027

Tupelo, MS 388034027

Phone: 6623774685

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.