Individual provider Active NPI

Tamela F Mathis, FNP-C

  • Family Nurse Practitioner
  • Ridgeland, MS
National Provider Identifier
1578043337
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902751 Issued in MS
Practice address
1051 Highland Colony Pkwy Ste E
Ridgeland, MS 39157-7701
Phone
(601) 707-3737
Fax
(601) 853-2299
NPI assigned
Aug 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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 902751 MS Primary

Addresses

Primary practice location

1051 Highland Colony Pkwy Ste E
Ridgeland, MS 39157-7701

Mailing address

1051 Highland Colony Pkwy Ste E
Ridgeland, MS 39157-7701
Phone (601) 707-3737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20220224000342 TX Practitioner - Nurse Practitioner 4486908670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Carenow Urgent Care PLLCGroup PAC ID 3274808043, 71 clinicians

Practice addresses (Care Compare)

20780 US Hwy 281 N
Carenow
San Antonio, TX 78258-7501
Phone (210) 963-8455

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
902751MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. David'S Carenow Urgent Care PLLC CurrentSince Jun 1, 2022 Accepting new patients
Methodist Carenow Urgent Care PLLC CurrentSince Apr 10, 2022 Accepting new patients
Trustcare Primary Care, LLC Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

5033 W Highway 290
Austin, TX 78735
Phone (512) 265-8980

20780 US Highway 281 N
San Antonio, TX 78258
Phone (210) 963-8445

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1578043337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 HIGHLAND COLONY PKWY STE E",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391577701",
            "telephone_number": "601-707-3737",
            "fax_number": "601-853-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 HIGHLAND COLONY PKWY STE E",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391577701",
            "telephone_number": "601-707-3737",
            "fax_number": "601-853-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "TAMELA",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

Verify at the official NPI Registry.