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WANYA PRIDGEN
NPI 1245080753
Student in an Organized Health Care Education/Training Program in Jackson, MS

Active since March 26, 2024PECOS Enrolled
2500 N STATE ST, JACKSON, MS 39216(601) 984-1113 Get Directions Write a Review

NPPES record last updated: March 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Wanya Pridgen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WANYA PRIDGEN (NPI 1245080753) is an individual student in an organized health care education/training program in Jackson, Mississippi and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245080753
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameWANYA PRIDGEN
Location Address2500 N STATE STJackson, MS 39216-4500
Mailing Address2500 N State StJackson, MS 39216-4500 · (601) 815-0600
Phone(601) 984-1113
Sole ProprietorNo
Enumeration DateMarch 26, 2024
NPPES CertifiedMarch 25, 2024
✔ NPI 1245080753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2500 N STATE ST, Jackson, MS 39216
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wanya Pridgen is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAMAR DAVIS II M.D.
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5275
STEPHEN COMMISKEY M.D.
Anesthesiology
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5900
JESSICA SAFLEY MD
Anesthesiology
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5900
DR. MARY KINNEY LOWE CORLEY MD
Obstetrics & Gynecology
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5339
LAURA ELIZABETH VEARRIER M.D.
Emergency Medicine
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 815-2005
DR. CANDICE BRITTANY APRIL DDS
Dentist
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-6028
DR. LARKIN H MITCHELL M.D.
Anesthesiology
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-5900
EMILY SUMRALL CHILDRESS CRNA
Nurse Anesthetist, Certified Registered
2500 N STATE ST
JACKSON, MS 39216
Hinds County (601) 984-1000

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 Wanya Pridgen's NPI number?

The NPI number for Wanya Pridgen is 1245080753. It was assigned to this individual provider in the NPPES registry on March 26, 2024.

Where is Wanya Pridgen located?

Wanya Pridgen practices at 2500 N State St, Jackson, MS 39216. The listed phone number is (601) 984-1113.

What is Wanya Pridgen's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Wanya Pridgen enrolled in Medicare?

Yes. Wanya Pridgen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Wanya Pridgen was last updated on March 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.