Tiffany Gomez-Grubb – Family Nurse Practitioner

Key facts

NPI: 1275422339
Entity type: Individual (NPI type 1)
Primary specialty: Family Nurse Practitioner 363LF0000X
License: 208272 (LA)
Practice address: 324 Plantation Hills Blvd
Stonewall, LA 71078-2838
Phone: (318) 531-8543
NPI assigned: Jul 1, 2025
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Magnolia Family Medicine, LLC Family Medicine Physician · Stonewall, LA · NPI 1861274102

Medicare reassignment Care Compare group NPD LA

Hospital & facility affiliations 5

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

Christus Health Northern Louisiana General Acute Care Hospital · Shreveport, LA · NPI 1417950106

Care Compare affiliation Hospital
Willis Knighton Medical Center, Inc. General Acute Care Hospital · Bossier City, LA · NPI 1003968579

Care Compare affiliation Hospital
Willis Knighton Medical Center, Inc. General Acute Care Hospital · Shreveport, LA · NPI 1124170691

Care Compare affiliation Hospital
Willis Knighton Medical Center, Inc. General Acute Care Hospital · Shreveport, LA · NPI 1275685539

Care Compare affiliation Hospital
Willis Knighton Medical Center, Inc. General Acute Care Hospital · Shreveport, LA · NPI 1568461572

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2025
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Magnolia Family Medicine, LLC (2 clinicians)

Practice addresses (Care Compare)

324 Plantation Hills Blvd
Stonewall, LA 71078-2838
Phone (318) 531-8543

Hospital & facility affiliations

Christus Shreveport-Bossier Health System Hospital · Shreveport, LA · CCN 190041
Willis Knighton Medical Center Hospital · Shreveport, LA · CCN 190111

Medicare participation

Medicare fee-for-service enrollment: Enrolled in LA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20251105000194	LA	Practitioner - Nurse Practitioner	8921598319	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

State licenses

License	State	Type	Specialty
208272	LA	MD	Family Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Magnolia Family Medicine, LLC		Current since Aug 1, 2025	Accepting new patients

Interoperability endpoints

FHIR API: https://fhir4.healow.com/fhir/r4/GJAEDD/Endpoint/GJAEDD

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner	363LF0000X	208272	LA	Yes

Addresses

Primary practice location

324 Plantation Hills Blvd
Stonewall, LA 71078-2838

Mailing address

324 Plantation Hills Blvd
Stonewall, LA 71078-2838

Other providers in Stonewall, LA

All providers in Stonewall, LA · Family Nurse Practitioner in Louisiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.