NPIMap

Individual provider Active NPI

Tia Heskett, APRN

  • Family Nurse Practitioner
  • Poplar Bluff, MO
National Provider Identifier
1487249306
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2020018542 Issued in MO
Practice address
225 Physicians Park Ste 203
Poplar Bluff, MO 63901-3921
Phone
(475) 057-3686
NPI assigned
Mar 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2020018542 MO Primary

Addresses

Primary practice location

225 Physicians Park Ste 203
Poplar Bluff, MO 63901-3921

Mailing address

3401 Fairfax Rd
Kennett, MO 63857-7505
Phone (573) 717-6913

Other identifiers 2

IdentifierTypeStateIssuer
2020018542OtherMOAPRN LICENSE NUMBER
213455OtherARARKANSAS APRN LICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL tiagmitchell.93@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20210804001579 MO Practitioner - Nurse Practitioner 2860896479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Missouri Health Network 19 clinicians

Practice addresses (Care Compare)

200 Southland Dr
Sikeston, MO 63801-4403
Phone (573) 472-1770

500 Russell St
Kennett, MO 63857-2102
Phone (573) 717-1332

6724 State Hwy 77
Benton, MO 63736-8238
Phone (573) 545-4200

6738 State Hwy 77
Benton, MO 63736-8238

741 S Walnut St
Bernie, MO 63822-8900
Phone (573) 293-6838

Hospital & facility affiliations

  • Elara Caring Home health agency, Dexter, MO, CCN 267589
  • Mercy Hospital Stoddard Hospital, Dexter, MO, CCN 260160
  • Poplar Bluff Regional Medical Center Hospital, Poplar Bluff, MO, CCN 260119
  • Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110
  • Saint Francis Medical Center Hospital, Cape Girardeau, MO, CCN 260183

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Missouri Health Network CurrentSince Jan 1, 2022 Accepting new patients
Southeast Missouri Health Network Current Accepting new patients
Southeast Missouri Health Network CurrentSince Jan 1, 2022 Accepting new patients
Poplar Bluff Hma Physician Management, LLC PastSince Aug 15, 2021 Accepting new patients

Locations

6724 State Highway 77
Benton, MO 63736
Phone (573) 545-4191

741 S Walnut St
Bernie, MO 63822
Phone (573) 293-6836

109 E 5th St
Caruthersville, MO 63830
Phone (573) 359-9803

500 Russell St
Kennett, MO 63857
Phone (573) 717-1332

310 US Highway 61
New Madrid, MO 63869
Phone (573) 688-2161

655 US Highway 61
New Madrid, MO 63869
Phone (573) 545-4200

200 Southland Dr
Sikeston, MO 63801
Phone (573) 472-1770

200 Pine St
Sikeston, MO 63801
Phone (573) 313-2500

835 W Murray Ln
Sikeston, MO 63801
Phone (573) 472-8808

Interoperability endpoints

  • Direct secure messaging: tia.heskett.1@14764.direct.athenahealth.com

Organizations & group practices 10

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.

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": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1487249306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 FAIRFAX RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638577505",
            "telephone_number": "573-717-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PHYSICIANS PARK STE 203",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013921",
            "telephone_number": "475-057-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HESKETT",
        "first_name": "TIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020018542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE NUMBER",
            "identifier": "2020018542",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS APRN LICENSE NUMBER",
            "identifier": "213455",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "tiagmitchell.93@gmail.com",
            "affiliation": "N",
            "address_1": "225 Physicians Park Ste 203",
            "city": "Poplar Bluff",
            "state": "MO",
            "country_code": "US",
            "postal_code": "639013921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.