Individual provider Active NPI

Tiffany Shannon Ray, CRNA

  • Certified Registered Nurse Anesthetist
  • Horn Lake, MS
National Provider Identifier
1114097615
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
864509 Issued in MS
Practice address
6410 Walnut Grove Rd
Horn Lake, MS 38637-2023
Phone
(901) 652-0880
NPI assigned
Nov 9, 2006
Last updated
Feb 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 15099 TN
Certified Registered Nurse Anesthetist 367500000X 864509 MS Primary

Addresses

Primary practice location

6410 Walnut Grove Rd
Horn Lake, MS 38637-2023

Mailing address

PO Box 381468
Germantown, TN 38183-1468

Other practice location 1

1208 Office Park Dr
Oxford, MS 38655-3597
Phone (662) 234-9888

Other practice location 2

7900 Airways Blvd Ste 101
Southaven, MS 38671-4113
Phone (662) 349-6950

Other practice location 3

1208 Office Park Dr
Oxford, MS 38655-3597
Phone (662) 234-9888

Other practice location 4

8000 Wolf River Blvd Ste 200
Germantown, TN 38138-1755
Phone (901) 747-3630

Other identifiers 2

IdentifierTypeStateIssuer
200020616MedicaidMS
Q057613MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050722000275 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153358072 Reassigns benefits to 3 organizations
I20120511000481 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153358072 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resource Anesthesiology Associates of TN PCGroup PAC ID 8527419092, 145 clinicians
Mid-South Imaging and Therapeutics, P.a.Group PAC ID 9133106396, 69 clinicians
Anesthesia Solutions LLCGroup PAC ID 1557770096, 8 clinicians
Gastroenterology Center of the Midsouth PLLCGroup PAC ID 4880619824, 148 clinicians

Practice addresses (Care Compare)

1265 Union Ave
Suite 201
Memphis, TN 38104-3415
Phone (901) 516-7000

6286 Briarcrest Ave
Suite 300
Memphis, TN 38120-4023
Phone (901) 473-6405

6485 Poplar Ave
Memphis, TN 38119-4838
Phone (901) 767-3937

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (901) 383-9478

8000 Wolf River Blvd
Suite 200
Germantown, TN 38138-1755
Phone (901) 684-5503

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
15099TNMDSocial Worker
864509MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Imaging & Therapeutics, P.a. Nurse Anesthetist, Certified Registered CurrentSince May 1, 2024 Accepting new patients
Mid-South Vascular Physicians PLLC CurrentSince May 20, 2024 Accepting new patients
Ut Regional One Physicians Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2024 Accepting new patients
Midsouth Speciality Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince May 30, 2024 Accepting new patients
Ut Regional One Physicians Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2025 Accepting new patients
Resource Anesthesiology Associates of TN PC Nurse Anesthetist, Certified Registered CurrentSince Oct 27, 2025 Accepting new patients
Gastroenterology Center of the Midsouth PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 2, 2012 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Dec 1, 2024 Accepting new patients
Anesthesia Solutions LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 28, 2025 Accepting new patients
G I Diagnostic and Therapeutic Center LLC Current Accepting new patients
Specialty Physician Group LLC Past Accepting new patients
Anesthesia Health Consultants Nurse Anesthetist, Certified Registered PastSince May 20, 2024 Accepting new patients
Gastrointestinal Specialists Foundation, Inc Nurse Anesthetist, Certified Registered PastSince Nov 13, 2023 Accepting new patients

Locations (25 of 31)

400 10th St E
Waconia, MN 55387

1208 Office Park Dr
Oxford, MS 38655
Phone (662) 234-9888

403 Getwell Dr
Senatobia, MS 38668
Phone (662) 301-2130

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

7668 Airways Blvd
Bldg 2
Southaven, MS 38671
Phone (901) 766-9490

7736 Airways Blvd
Southaven, MS 38671
Phone (662) 772-3700

7900 Airways Blvd
Bldg B100
Southaven, MS 38671
Phone (662) 349-2442

7900 Airways Blvd
Ste 101
Southaven, MS 38671
Phone (662) 349-6950

589 Garfield St
Ste 201
Tupelo, MS 38801
Phone (662) 680-5565

450 Mamaroneck Ave
Ste 201
Harrison, NY 10528
Phone (877) 476-6642

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Gastro Onegovt Arhcl
New York, NY 10087

1500 W Poplar Ave
Collierville, TN 38017
Phone (901) 227-8140

670 N Germantown Pkwy
Ste 18
Cordova, TN 38018
Phone (901) 753-7686

1310 Wolf Park Dr
Germantown, TN 38138
Phone (901) 624-5151

1355 W Brierbrook Rd
Germantown, TN 38138
Phone (901) 755-8300

27 Medical Center Dr
#A
Jackson, TN 38301
Phone (731) 280-0157

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

1265 Union Ave
Ste 201
Memphis, TN 38104
Phone (901) 516-7000

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

1325 Eastmoreland Ave
Ste 410
Memphis, TN 38104
Phone (901) 261-6650

1750 Madison Ave
Ste 300
Memphis, TN 38104
Phone (901) 725-7025

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

6225 Humphreys Blvd
Memphis, TN 38120
Phone (901) 227-2727

6286 Briarcrest Ave
Ste 300
Memphis, TN 38120
Phone (901) 473-6405

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1114097615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381468",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381831468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 WALNUT GROVE RD",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386372023",
            "telephone_number": "901-652-0880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1208 Office Park Dr",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386553597",
            "country_code": "US",
            "telephone_number": "662-234-9888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7900 Airways Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386714113",
            "country_code": "US",
            "telephone_number": "662-349-6950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1208 Office Park Dr",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386553597",
            "country_code": "US",
            "telephone_number": "662-234-9888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8000 Wolf River Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381755",
            "country_code": "US",
            "telephone_number": "901-747-3630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "TIFFANY",
        "middle_name": "SHANNON",
        "name_prefix": "Miss",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "15099",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "864509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200020616",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q057613",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Horn Lake, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.