Individual provider Active NPI

Christina Marie Gardner

  • Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1154913895
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
904443 Issued in MS
Practice address
830 S Gloster St
Tupelo, MS 38801-4934
Phone
(662) 377-2539
Fax
(662) 377-2920
NPI assigned
Feb 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 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 904443 MS Primary

Addresses

Primary practice location

830 S Gloster St
Tupelo, MS 38801-4934

Mailing address

808 Varsity Dr
Tupelo, MS 38801-4613
Phone (662) 377-2539

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
I20210305000319 MS Practitioner - Nurse Practitioner 6709292386 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
904443MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Medical Center Inc. CurrentSince Feb 2, 2021 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Feb 2, 2021 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center, Inc. Past Accepting new patients

Locations

808 Varsity Dr
Tupelo, MS 38801
Phone (662) 377-2386

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: christinawilliams@nmhs.medalliesdirect.net

Organizations & group practices 12

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.

Hospital & facility affiliations 2

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Mississippi Medical Center, Inc. 361 clinicians

Practice addresses (Care Compare)

830 S Gloster St
Tupelo, MS 38801-4934
Phone (662) 377-3000

Hospital & facility affiliations

  • North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004
  • Pontotoc Health Service Inc Cah Hospital, Pontotoc, MS, CCN 251308

NPI Registry JSON

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1154913895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 VARSITY DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014613",
            "telephone_number": "662-377-2539",
            "fax_number": "662-377-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-377-2539",
            "fax_number": "662-377-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-04",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "904443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.