Tenn-Tom Med LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

TENN-TOM MED LLC

Practice address

369 Highway 72
Burnsville, MS 38833-9320

Phone

(662) 427-4040

Fax

(662) 427-4041

NPI assigned

Sep 23, 2021

Organization subpart

No

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

Authorized official

Name

Camille Whitehead, NPNPI 1427556828

Title

Managing Nurse Practitioner

Phone

(662) 427-4040

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Camille Whitehead, FNP-BC

  • Family Nurse Practitioner
  • Burnsville, MS
  • NPI 1427556828
  Medicare reassignment NPD Authorized official
• Jennifer Lee Dawson, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Iuka, MS
  • NPI 1710959283
  Medicare reassignment NPD

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650499200000",
    "number": "1174294797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 214",
            "city": "BURNSVILLE",
            "state": "MS",
            "postal_code": "388330214",
            "telephone_number": "662-427-4040",
            "fax_number": "662-427-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 HIGHWAY 72",
            "city": "BURNSVILLE",
            "state": "MS",
            "postal_code": "388339320",
            "telephone_number": "662-427-4040",
            "fax_number": "662-427-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENN-TOM MED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-23",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "CAMILLE",
        "authorized_official_title_or_position": "MANAGING NURSE PRACTITIONER",
        "authorized_official_telephone_number": "662-427-4040",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Dianne Feltman, FNP-C
• Tami Bivins Johnson, FNP
• Daniel Evan Koehlinger, RN, WCC
• Magnolia Regional Health Center
• Katelyn Shaw
• Tishomingo Health Services, Inc.
• Jonathan Wadkins, NP
• Camille Whitehead, FNP-BC
• Rebecca Kay Williams, RN

• Primary Care Clinic/Center in Burnsville, MS
• Providers in Burnsville, MS by specialty
• Primary Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.