Andrea Koosne Garrison, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

17069 Issued in MS

Practice address

4577 S Eason Blvd
Tupelo, MS 38801-6590

Phone

(662) 377-7590

Fax

(662) 377-7595

NPI assigned

Jun 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• North Mississippi Medcial Center, Inc.

  • Diagnostic Radiology Physician
  • Tupelo, MS
  • NPI 1902762487
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1316984149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1937 BRIAR RIDGE RD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388045963",
            "telephone_number": "662-690-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4577 S EASON BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016590",
            "telephone_number": "662-377-7590",
            "fax_number": "662-377-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "ANDREA",
        "middle_name": "KOOSNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "17069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08226071",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethany Garner, PA-C
• Evan Fuller Garner, M.D.
• Luke Garner, MA, LPC, NCC
• Matthew Logan Garner, PA-C
• Susan Fretwell Garner, CFNP
• Rachel Garrison
• Lycedia Gasaway
• Sherry Lynn Gaskin, NP
• Shameena Gaston
• Sharon Gates-Albert, LPC

• Psychiatry Physician in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Psychiatry Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.