Active NPI
Tia Anthony, NP
- Nurse Practitioner
- Crawford, MS
National Provider Identifier
1164255121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 906789
- Practice address
- 79 Clark Rd
Crawford, MS 39743-9472 - Phone
- (662) 574-9799
- NPI assigned
- Aug 23, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 906789 | MS | Primary |
Addresses
Primary practice location
79 Clark Rd
Crawford, MS 39743-9472
Mailing address
79 Clark Rd
Crawford, MS 39743-9472
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
200 Corporate Blvd
Lafayette, LA 70508-3844
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 906789 | MS | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724371200000",
"number": "1164255121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 CLARK RD",
"city": "CRAWFORD",
"state": "MS",
"postal_code": "397439472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 CLARK RD",
"city": "CRAWFORD",
"state": "MS",
"postal_code": "397439472",
"telephone_number": "662-574-9799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTHONY",
"first_name": "TIA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-23",
"last_updated": "2024-08-23",
"certification_date": "2024-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "906789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crawford, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.
- 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.