Individual provider Active NPI

Tiana Justine Bridges, OTR/L

  • Occupational Therapist
  • Southaven, MS
National Provider Identifier
1134099559
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-4364 Issued in MS
Practice address
7111 Southcrest Pkwy Ste 105
Southaven, MS 38671-4851
Phone
(901) 261-2506
Fax
(901) 261-2590
NPI assigned
Nov 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-4364 MS Primary
Occupational Therapist 225X00000X 8628 TN

Addresses

Primary practice location

7111 Southcrest Pkwy Ste 105
Southaven, MS 38671-4851

Mailing address

6077 E Primacy Pkwy Ste 140
Memphis, TN 38119-5754
Phone (901) 725-8347

Other practice location 1

6286 Briarcrest Ave Ste 110
Memphis, TN 38120-4023
Phone (901) 261-2506

Other identifiers 2

IdentifierTypeStateIssuer
8628OtherTNTN LICENSE
OT-4364OtherMSMS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260512002036 TN Practitioner - Occupational Therapist in Private Practice 9931678653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MSK Group PCGroup PAC ID 4688574262, 138 clinicians

Practice addresses (Care Compare)

6286 Briarcrest Ave
Suite 200
Memphis, TN 38120-4023
Phone (901) 641-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26682CAMDPeriodontist
8628TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group, PC Occupational Therapist CurrentSince Apr 13, 2026 Accepting new patients
MSK Group, PC PastSince Apr 13, 2026 Accepting new patients

Locations

7111 Southcrest Pkwy
Ste 105
Southaven, MS 38671
Phone (901) 261-2506

6286 Briarcrest Ave
#200
Memphis, TN 38120
Phone (901) 259-1600

6077 E Primacy Pkwy
Ste 140
Memphis, TN 38119
Phone (901) 725-8347

6286 Briarcrest Ave
Memphis, TN 38120
Phone (901) 259-1600

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1134099559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6077 E PRIMACY PKWY STE 140",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195754",
            "telephone_number": "901-725-8347",
            "fax_number": "901-259-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 SOUTHCREST PKWY STE 105",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714851",
            "telephone_number": "901-261-2506",
            "fax_number": "901-261-2590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6286 Briarcrest Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381204023",
            "country_code": "US",
            "telephone_number": "901-261-2506",
            "fax_number": "901-261-2590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "TIANA",
        "middle_name": "JUSTINE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-10",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT-4364",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "8628",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN LICENSE",
            "identifier": "8628",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS LICENSE",
            "identifier": "OT-4364",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.