Individual provider Active NPI

Tommie Brian Stretch, M.D.

  • Pediatrics Physician
  • Natchez, MS
National Provider Identifier
1174576730
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
019243 Issued in LA
Practice address
55 Sergeant Prentiss Dr
Suite 7
Natchez, MS 39120-4782
Phone
(601) 445-9543
Fax
(601) 445-9803
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 12805 MS
Pediatrics Physician 208000000X 019243 LA Primary
Pediatrics Physician 208000000X 0101283243 VA

Addresses

Primary practice location

55 Sergeant Prentiss Dr
Suite 7
Natchez, MS 39120-4782

Mailing address

55 SGT Prentiss Dr
Natchez, MS 39120-4740
Phone (601) 445-9543

Other practice location 1

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000

Other identifiers 2

IdentifierTypeStateIssuer
00113941MedicaidMS
1928291MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
019243LAMDPediatrics Physician
12805MSMDPediatrics Physician
0101283243VAMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: tstretch16149@ummc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1174576730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SGT PRENTISS DR",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391204740",
            "telephone_number": "601-445-9543",
            "fax_number": "601-445-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SERGEANT PRENTISS DR",
            "address_2": "SUITE 7",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391204782",
            "telephone_number": "601-445-9543",
            "fax_number": "601-445-9803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1514 Jefferson Hwy",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701212429",
            "country_code": "US",
            "telephone_number": "504-842-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STRETCH",
        "first_name": "TOMMIE",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "12805",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "019243",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101283243",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00113941",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1928291",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchez, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.