NPIMap

Individual provider Active NPI

Takiffany Jean Palmer, FNP

  • Family Nurse Practitioner
  • Ocean Springs, MS
National Provider Identifier
1215418975
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902872 Issued in MS
Practice address
3890 Bienville Blvd
Ocean Springs, MS 39564
Phone
(228) 872-6291
NPI assigned
Aug 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 902872 MS Primary
Family Nurse Practitioner 363LF0000X MCLE-K4905P MS

Addresses

Primary practice location

3890 Bienville Blvd
Ocean Springs, MS 39564

Mailing address

3890 Bienville Blvd
Ocean Springs, MS 39564-5803
Phone (228) 872-6291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180926000249 MS Practitioner - Nurse Practitioner 1456602739 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

4500 W Railroad St
Gulfport, MS 39501-2479
Phone (228) 863-8836

Hospital & facility affiliations

  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019
  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123
  • Singing River Health System Hospital, Pascagoula, MS, CCN 250040
  • George Regional Health System Hospital, Lucedale, MS, CCN 250036

Merit-based Incentive Payment System (MIPS)

Final score
76.9 of 100Reported as group
Quality
47.44
Promoting interoperability
98
Improvement activities
40
Cost
77.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
902872MSMDFamily Nurse Practitioner
MCLE-K4905PMSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Gastrointestinal Associates, P.a. Current Accepting new patients
Gastrointestinal Associates, PA CurrentSince Jun 19, 2023 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Sep 1, 2024 Accepting new patients
Gastrointestinal Associates, P.a. CurrentSince Jun 19, 2023 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

1720A Medical Park Dr
Ste 300
Biloxi, MS 39532
Phone (228) 702-1500

147 Reynoir St
Ste 301
Biloxi, MS 39530
Phone (228) 374-7949

4500 W Railroad St
Gulfport, MS 39501
Phone (228) 863-8836

1421 N State St
Ste 203
Jackson, MS 39202
Phone (601) 355-1234

90 Industrial Park Cir
#A
Ocean Springs, MS 39564
Phone (228) 872-6291

3890 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 872-6291

Organizations & group practices 8

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 64

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

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1215418975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 BIENVILLE BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395645803",
            "telephone_number": "228-872-6291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 BIENVILLE BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "39564",
            "telephone_number": "228-872-6291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "TAKIFFANY",
        "middle_name": "JEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902872",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "MCLE-K4905P",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

Verify at the official NPI Registry.