NPIMap

Individual provider Active NPI

Tippini K Conley, CFNP

  • Nurse Practitioner
  • Oakland, MS
National Provider Identifier
1275789935
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R866055 Issued in MS
Practice address
14101 Hickory Street
Oakland, MS 38948-0000
Phone
(662) 623-7319
Fax
(662) 473-4991
NPI assigned
Aug 13, 2008
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R866055 MS Primary

Addresses

Primary practice location

14101 Hickory Street
Oakland, MS 38948-0000

Mailing address

14101 Hickory Street
Oakland, MS 38948-0000
Phone (662) 623-7319

Other identifiers 2

IdentifierTypeStateIssuer
01802340MedicaidMS
512I500752OtherMSMEDICARE PTAN

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
I20090312000606 MS Practitioner - Nurse Practitioner 6305902537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yalobusha General HospitalGroup PAC ID 4486601648, 19 clinicians

Practice addresses (Care Compare)

11334 Hwy 315
Water Valley, MS 38965

PO Box
Suite 728
Water Valley, MS 38965

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Strategic Solutions-Panola Medical Center LLC CurrentSince Jun 22, 2020 Accepting new patients
Yalobusha General Hospital Nurse Practitioner CurrentSince Feb 2, 2018 Accepting new patients
Strategic Solutions-Panola Medical Center LLC CurrentSince Jun 22, 2020 Accepting new patients
Yalobusha General Hospital Current Accepting new patients
Panola Physician Group, LLC Past Accepting new patients
Yalobusha General Hospital Past Accepting new patients

Locations

155 Keating Rd
Batesville, MS 38606
Phone (601) 978-3366

255 Medical Center Dr
Batesville, MS 38606
Phone (662) 563-2163

303 Medical Center Dr
Batesville, MS 38606
Phone (662) 563-0155

604 S Main St
Water Valley, MS 38965
Phone (662) 473-1311

Interoperability endpoints

  • Direct secure messaging: tippini.lott.1@15461.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1275789935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14101 HICKORY STREET",
            "city": "OAKLAND",
            "state": "MS",
            "postal_code": "389480000",
            "telephone_number": "662-623-7319",
            "fax_number": "662-473-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14101 HICKORY STREET",
            "city": "OAKLAND",
            "state": "MS",
            "postal_code": "389480000",
            "telephone_number": "662-623-7319",
            "fax_number": "662-473-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "TIPPINI",
        "middle_name": "K",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R866055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01802340",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "512I500752",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, MS

Sources for this page

Verify at the official NPI Registry.