Individual provider Active NPI

Tara Wadkins, CRNA

  • Certified Registered Nurse Anesthetist
  • Corinth, MS
National Provider Identifier
1265563365
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R857140 Issued in MS
Practice address
611 Alcorn Dr
Corinth, MS 38834-9368
Phone
(662) 293-1440
Fax
(662) 293-4334
NPI assigned
Mar 8, 2007
Last updated
Oct 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 25215 TN
Certified Registered Nurse Anesthetist 367500000X R857140 MS Primary

Addresses

Primary practice location

611 Alcorn Dr
Corinth, MS 38834-9368

Mailing address

611 Alcorn Dr
Corinth, MS 38834-9321
Phone (662) 293-1440

Other names 1

  • Tara Ray Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN, AL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20070531000519 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719085687 Reassigns benefits to 4 organizations
I20200513002677 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719085687
I20230606002346 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719085687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magnolia Gastroenterology Clinic LLCGroup PAC ID 6800844507, 5 clinicians

Practice addresses (Care Compare)

3050 Corder Dr
Corinth, MS 38834-6210
Phone (662) 284-9902

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R857140MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 30, 2023 Accepting new patients
Willow Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2019 Accepting new patients
Delta Health System Nurse Anesthetist, Certified Registered CurrentSince May 8, 2021 Accepting new patients
Sola Medical Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2020 Accepting new patients
Magnolia Gastroenterology Clinic, LLC CurrentSince Nov 9, 2021 Accepting new patients
Namc Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2023 Accepting new patients
Magnolia Endoscopy Center, LLC PastSince Nov 9, 2021 Accepting new patients
East Memphis Anesthesia Services, PLLC Past Accepting new patients

Locations

1701 Veterans Dr
Florence, AL 35630
Phone (256) 629-1900

1970 Hospital Dr
Clarksdale, MS 38614
Phone (662) 624-3185

3050 Corder Dr
Corinth, MS 38834
Phone (662) 284-9902

306 Bradley Rd
#A
Corinth, MS 38834
Phone (662) 285-6060

1400 E Union St
Greenville, MS 38703
Phone (601) 427-0422

960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000

110 Walker Way
Starkville, MS 39759
Phone (662) 320-6555

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1265563365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349321",
            "telephone_number": "662-293-1440",
            "fax_number": "662-293-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349368",
            "telephone_number": "662-293-1440",
            "fax_number": "662-293-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADKINS",
        "first_name": "TARA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "25215",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R857140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "RAY",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corinth, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.