Individual provider Active NPI

Tiffany Yvette Boone, NP

  • Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1033845771
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
905376 Issued in MS
Practice address
6051 U S Highway 49
Hattiesburg, MS 39401-7201
Phone
(601) 264-6000
NPI assigned
Jul 26, 2022
Last updated
May 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 905376 MS Primary

Addresses

Primary practice location

6051 U S Highway 49
Hattiesburg, MS 39401-7201

Mailing address

5402 Highway 43
Newhebron, MS 39140-5472
Phone (601) 455-4259

Other practice location 1

950 Matthew Dr
Waynesboro, MS 39367-2590
Phone (601) 735-5151

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220912001173 MS Practitioner - Nurse Practitioner 3375928351 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wayne General HospitalGroup PAC ID 2668457581, 47 clinicians

Practice addresses (Care Compare)

950 Matthew Dr
Waynesboro, MS 39367-2567
Phone (601) 735-5151

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
905376MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne General Hospital Current Accepting new patients
Wayne General Hospital CurrentSince Jun 1, 2023 Accepting new patients
Hattiesburg Clinic PA CurrentSince Aug 29, 2022 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Aug 29, 2022 Accepting new patients
Wayne General Hospital CurrentSince Jun 1, 2023 Accepting new patients
Wayne General Hospital Past Accepting new patients
Wayne General Hospsital Past Accepting new patients

Locations

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

940 Matthew Dr
Ste 5
Waynesboro, MS 39367
Phone (601) 735-7285

950 Matthew Dr
Waynesboro, MS 39367
Phone (601) 735-5151

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1033845771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5402 HIGHWAY 43",
            "city": "NEWHEBRON",
            "state": "MS",
            "postal_code": "391405472",
            "telephone_number": "601-455-4259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 U S HIGHWAY 49",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017201",
            "telephone_number": "601-264-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 Matthew Dr",
            "address_purpose": "LOCATION",
            "city": "Waynesboro",
            "state": "MS",
            "postal_code": "393672590",
            "country_code": "US",
            "telephone_number": "601-735-5151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOONE",
        "first_name": "TIFFANY",
        "middle_name": "YVETTE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "905376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.