Individual provider Active NPI

Tiffany Li McElroy, O.D.

  • Optometrist
  • Olive Branch, MS
National Provider Identifier
1295081024
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
857 Issued in MS
Practice address
6947 Crumpler Blvd
Suite 100
Olive Branch, MS 38654-1922
Phone
(662) 893-3300
NPI assigned
Jul 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 857 MS Primary

Addresses

Primary practice location

6947 Crumpler Blvd
Suite 100
Olive Branch, MS 38654-1922

Mailing address

6947 Crumpler Blvd
Suite 100
Olive Branch, MS 38654-1922
Phone (662) 893-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121003000783 MS Practitioner - Optometry 8426207630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care AssociatesGroup PAC ID 5395761910, 5 clinicians

Practice addresses (Care Compare)

1431 W 10TH St
Laurel, MS 39440-2626
Phone (601) 649-1437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
857MSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates Optometrist CurrentSince May 1, 2019 Accepting new patients
Eye Care Associates CurrentSince May 1, 2019 Accepting new patients

Locations

602 Hill St
Ellisville, MS 39437
Phone (601) 719-0092

1431 W 10th St
Laurel, MS 39440
Phone (601) 649-1437

1431 W 10th St
Ste 5
Laurel, MS 39440
Phone (601) 649-1437

519 Mississippi Dr
Waynesboro, MS 39367
Phone (601) 735-2878

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1295081024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6947 CRUMPLER BLVD",
            "address_2": "SUITE 100",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541922",
            "telephone_number": "662-893-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6947 CRUMPLER BLVD",
            "address_2": "SUITE 100",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541922",
            "telephone_number": "662-893-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCELROY",
        "first_name": "TIFFANY",
        "middle_name": "LI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

Verify at the official NPI Registry.