Individual provider Active NPI

Timothy Scott Enfinger, NP

  • Acute Care Nurse Practitioner
  • Gautier, MS
National Provider Identifier
1538868955
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
905408 Issued in MS
Practice address
1400 Magnolia Bluff Dr
Gautier, MS 39553-1901
Phone
(228) 300-1967
NPI assigned
Feb 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 905408 MS Primary

Addresses

Primary practice location

1400 Magnolia Bluff Dr
Gautier, MS 39553-1901

Mailing address

1400 Magnolia Bluff Dr
Gautier, MS 39553-1901
Phone (228) 300-1967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, VA, MS, TN4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20231117002051 AL Practitioner - Nurse Practitioner 3971951666 Reassigns benefits to 1 organization
I20250219002473 VA Practitioner - Nurse Practitioner 3971951666 Reassigns benefits to 2 organizations
I20250930003862 MS Practitioner - Nurse Practitioner 3971951666 Reassigns benefits to 1 organization
I20260522001385 TN Practitioner - Nurse Practitioner 3971951666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Spring Physician Services, LLCGroup PAC ID 1254689482, 89 clinicians
Greenbrook Physician Services, LLCGroup PAC ID 5597267427, 70 clinicians

Practice addresses (Care Compare)

1900 Electric Rd
Salem, VA 24153-7474
Phone (540) 776-4000

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.26 of 100Reported as group
Quality
77.12
Promoting interoperability
100
Improvement activities
40
Cost
76.87

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrook Physician Services, LLC CurrentSince Oct 1, 2025 Accepting new patients
Valley Area Primary Care, LLC CurrentSince Oct 10, 2023 Accepting new patients
Kingsford Physician Services, LLC CurrentSince Nov 5, 2024 Accepting new patients
Lake Spring Physician Services, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

4800 48th St
Valley, AL 36854
Phone (334) 756-1401

267 Fob James Dr
Valley, AL 36854
Phone (334) 364-3330

200 Corporate Blvd
Lafayette, LA 70508

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

2400 Lee Hwy N
Pulaski, VA 24301
Phone (540) 994-8100

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

Interoperability endpoints

  • Direct secure messaging: tenfinger702368@direct.bmhcc.org

Organizations & group practices 5

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 2

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": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1538868955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MAGNOLIA BLUFF DR",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395531901",
            "telephone_number": "228-300-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MAGNOLIA BLUFF DR",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395531901",
            "telephone_number": "228-300-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENFINGER",
        "first_name": "TIMOTHY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-02-24",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "905408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gautier, MS

Sources for this page

Verify at the official NPI Registry.