Active NPI
Tommie Brian Stretch, M.D.
- Pediatrics Physician
- Natchez, MS
National Provider Identifier
1174576730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 019243
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00113941 | Medicaid | MS | |
| 1928291 | Medicaid | LA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019243 | LA | MD | Pediatrics Physician |
| 12805 | MS | MD | Pediatrics Physician |
| 0101283243 | VA | MD | Pediatrics Physician |
Interoperability endpoints
- 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.