Individual provider Active NPI

Tanya Jean Fitts, M.D

  • Pediatrics Physician
  • Oxford, MS
National Provider Identifier
1366451049
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
17111 Issued in MS
Practice address
2166 S Lamar Blvd
Oxford, MS 38655-5224
Phone
(662) 236-3939
Fax
(662) 236-3924
NPI assigned
Aug 5, 2006
Last updated
Jul 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 17111 MS Primary

Addresses

Primary practice location

2166 S Lamar Blvd
Oxford, MS 38655-5224

Mailing address

2166 S Lamar Blvd
Oxford, MS 38655-5224
Phone (662) 236-3939

Other practice location 1

1100 Belk Blvd
Oxford, MS 38655-5242
Phone (662) 636-1090

Other identifiers 1

IdentifierTypeStateIssuer
00125498MedicaidMS

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061023000395 MS Practitioner - Pediatric Medicine 1052318706 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc Pediatrics CurrentSince May 31, 2022 Accepting new patients
Comprehensive Hospitalists of Ms, LLC Current Accepting new patients
Comprehensive Hospitalists of Ms, LLC CurrentSince Nov 26, 2024 Accepting new patients
Comprehensive Hospitalists of Ms, LLC CurrentSince Nov 26, 2024 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince May 31, 2022 Accepting new patients
Baptist Memorial Hospital North Mississippi, Inc Past Accepting new patients
Lafayette Pediatric Clinic Past Accepting new patients
Children's Clinic of Oxford, P.a. Pediatrics Past Accepting new patients

Locations

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

1100 Belk Blvd
Oxford, MS 38655
Phone (662) 636-1000

Interoperability endpoints

  • Direct secure messaging: tfitts@lpc.pcc-direct.com

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1366451049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2166 S LAMAR BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555224",
            "telephone_number": "662-236-3939",
            "fax_number": "662-236-3924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2166 S LAMAR BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555224",
            "telephone_number": "662-236-3939",
            "fax_number": "662-236-3924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Belk Blvd",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386555242",
            "country_code": "US",
            "telephone_number": "662-636-1090",
            "fax_number": "662-636-1676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITTS",
        "first_name": "TANYA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "17111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125498",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.