Priscilla Tubbs, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

301 Fisher St RM 1G123
Keesler Afb, MS 39534-2508

Phone

(228) 376-0577

NPI assigned

May 20, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1053160275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4317 LOMA DEL NORTE DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799343776",
            "telephone_number": "915-538-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FISHER ST RM 1G123",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "395342508",
            "telephone_number": "228-376-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBBS",
        "first_name": "PRISCILLA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Louis Ten Eyck, MD
• Roger Shawn Thomas, MD
• Mathew Ray Thompson, CRNA
• Rachel Tindal, MD
• Lea Marie Trush, MD
• Rajesh Tuli, M.D.
• Usaf 81St Medical Group
• Tanner G Van Es, DO
• Amberly Rachel Vaughan, MD
• Jared C Vaughan, MD

• Student in an Organized Health Care Education/Training Program in Keesler Afb, MS
• Providers in Keesler Afb, MS by specialty
• Student in an Organized Health Care Education/Training Program in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.