Purple Magnolia Healthcare LLC
NPI 1932965563ActiveOrganization· Nurse Practitioner, Primary Care· Gulfport, MS
Nurse Practitioner, Primary Care in Gulfport, Mississippi, registered in NPPES in February 2024. The authorized official on file is Chancelyn Penn, Owner And Practitioner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1932965563 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 21, 2024 |
| Last updated in NPPES | Jun 18, 2024 |
| Certified by provider | Jun 18, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | — | — |
| Clinic/Center, Multi-Specialty | 261QM1300X | — | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MS) |
|---|
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