GWENDOLYN CORROTHERS ROYAL FNP-C
NPI 1174298293
Nurse Practitioner - Family in Vicksburg, MS
About Gwendolyn Corrothers Royal Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GWENDOLYN CORROTHERS ROYAL FNP-C (NPI 1174298293) is an individual family provider in Vicksburg, Mississippi, licensed in Mississippi (904875) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Gwendolyn Corrothers Royal Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Gwendolyn Corrothers Royal reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Vicksburg, MS 39183
- Reassigned Medicare billing, Mississippi enrollment
- 5 clinicians in this Medicare group
Ripley, MS 38663
- Reassigned Medicare billing, Mississippi enrollment
- 463 clinicians in this Medicare group
Dallas, TX 75244
- Reassigned Medicare billing, Mississippi enrollment
- 202 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 39183 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Gwendolyn Corrothers Royal's NPI number?
The NPI number for Gwendolyn Corrothers Royal is 1174298293. It was assigned to this individual provider in the NPPES registry on August 11, 2021.
Where is Gwendolyn Corrothers Royal located?
Gwendolyn Corrothers Royal practices at 919 Mission 66, Vicksburg, MS 39183. The listed phone number is (601) 262-2922.
What is Gwendolyn Corrothers Royal's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Gwendolyn Corrothers Royal enrolled in Medicare?
Yes. Gwendolyn Corrothers Royal is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Gwendolyn Corrothers Royal's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Gwendolyn Corrothers Royal reassigns Medicare benefits to 3 organizations: Vicksburg Holistic Healthcare, LLC (Vicksburg, MS), Fast Pace Mississippi, PLLC (Ripley, MS) and Signify Health, LLC (Dallas, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gwendolyn Corrothers Royal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Gwendolyn Corrothers Royal accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee list Gwendolyn Corrothers Royal as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Gwendolyn Corrothers Royal was last updated on November 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Gwendolyn Corrothers Royal, FNP-C · NPI 1174298293
Family physician in Vicksburg, Mississippi. Individual provider, active in the CMS NPPES registry since August 11, 2021.
## Identity
- **NPI:** 1174298293 (Entity type: Individual)
- **Enumerated:** August 11, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 904875 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 919 MISSION 66, Vicksburg, MS 39183-2751
- **Phone:** (601) 262-2922
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Vicksburg Holistic Healthcare, LLC (NPI 1568816643, Vicksburg, MS); Fast Pace Mississippi, PLLC (NPI 1447769559, Ripley, MS); Signify Health, LLC (NPI 1689158487, Dallas, TX) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 18, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1174298293) · Data from the CMS NPPES public registry.