Tessie Renee Handy, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00328 Issued in MS

Practice address

6501 Dogwood View Pkwy Ste a
Jackson, MS 39213

Phone

(601) 899-3340

Fax

(601) 899-3343

NPI assigned

Apr 18, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tessie.handy.1@19209.direct.athenahealth.com

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.

• Relias Emergency Medicine Specialists of St Dominic LLC

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1235808122
  Medicare reassignment
• Modern Chiropractic of Florida

  • Chiropractor
  • Pace, FL
  • NPI 1154992733
  NPD (past)
• Pensacola Nephrology, PA

  • Nephrology Physician
  • Fort Walton Beach, FL
  • NPI 1871535955
  NPD (past)
• Renal Care Group of the Southeast, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pensacola, FL
  • NPI 1356453195
  NPD (past)

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1558895474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 RICE RD APT 26D",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391573019",
            "telephone_number": "662-809-8843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 DOGWOOD VIEW PKWY STE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39213",
            "telephone_number": "601-899-3340",
            "fax_number": "601-899-3343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1619 Creighton Rd",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325047152",
            "country_code": "US",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6001 Industrial Blvd",
            "address_purpose": "LOCATION",
            "city": "Century",
            "state": "FL",
            "postal_code": "325353312",
            "country_code": "US",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1717 N E St Ste 403",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325016334",
            "country_code": "US",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2940 N Blue Angel Pkwy",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325062925",
            "country_code": "US",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5149 N 9th Ave Ste G35",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325048733",
            "country_code": "US",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4583 Watkins St",
            "address_purpose": "LOCATION",
            "city": "Pace",
            "state": "FL",
            "postal_code": "325712511",
            "country_code": "US",
            "telephone_number": "850-889-4152",
            "fax_number": "850-623-3938",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4304 Lancaster Dr",
            "address_purpose": "LOCATION",
            "city": "Niceville",
            "state": "FL",
            "postal_code": "325784563",
            "country_code": "US",
            "telephone_number": "850-862-2385",
            "fax_number": "850-862-0482",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8880 Navarre Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Navarre",
            "state": "FL",
            "postal_code": "325663613",
            "country_code": "US",
            "telephone_number": "850-862-2385",
            "fax_number": "850-862-0482",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5934 Berryhill Medical Park Dr # 1",
            "address_purpose": "LOCATION",
            "city": "Milton",
            "state": "FL",
            "postal_code": "32570",
            "country_code": "US",
            "telephone_number": "850-623-4771",
            "fax_number": "850-623-3938",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14114 Alabama St",
            "address_purpose": "LOCATION",
            "city": "Jay",
            "state": "FL",
            "postal_code": "325651219",
            "country_code": "US",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1118 Gulf Breeze Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Gulf Breeze",
            "state": "FL",
            "postal_code": "325617806",
            "country_code": "US",
            "telephone_number": "850-444-4700",
            "fax_number": "850-434-8144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "319 Green Acres Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325471170",
            "country_code": "US",
            "telephone_number": "850-862-2385",
            "fax_number": "850-862-0482",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36474A Emerald Coast Pkwy Ste 1102",
            "address_purpose": "LOCATION",
            "city": "Destin",
            "state": "FL",
            "postal_code": "325413706",
            "country_code": "US",
            "telephone_number": "850-862-2385",
            "fax_number": "850-862-0482",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4415 US Highway 331 S",
            "address_purpose": "LOCATION",
            "city": "Defuniak Springs",
            "state": "FL",
            "postal_code": "324356307",
            "country_code": "US",
            "telephone_number": "850-398-6606",
            "fax_number": "850-398-6424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "221 E Redstone Ave",
            "address_purpose": "LOCATION",
            "city": "Crestview",
            "state": "FL",
            "postal_code": "325395373",
            "country_code": "US",
            "telephone_number": "850-398-6606",
            "fax_number": "850-398-6424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANDY",
        "first_name": "TESSIE",
        "middle_name": "RENEE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110327",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9110327",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSISSIPPI STATE DOH LICENSE",
            "identifier": "PA00328",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020748200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA STATE DOH LICENSE",
            "identifier": "PA9110327",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Alicia Hancock, MD
• John C Hancock, MD
• James William Hand, DPT
• Jervarkia Handy
• Keyaura Handy
• Valerie Logan Haney, FNP
• Hanger Prosthetics & Orthotics Inc
• William Charles Hanigan, MD
• Daniel Todd Hankins, MD
• Michael Wade Hankins, MD

• Physician Assistant in Jackson, MS
• Providers in Jackson, MS by specialty
• Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; 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.