Individual provider Active NPI

Tobi L Breland, N.P.

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1629177688
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
862455 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-5220
NPI assigned
Sep 22, 2006
Last updated
Mar 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 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 862455 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

504 Clinton Center Drive
Cbo-Suite 4300
Clinton, MS 39056-5610
Phone (601) 984-5220

Other identifiers 2

IdentifierTypeStateIssuer
1791164MedicaidLA
0771257MedicaidMS

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050111000573 MS Practitioner - Nurse Practitioner 3779531215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
862455MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jun 23, 2016 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jun 23, 2016 Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

1815 Hospital Dr
Jackson, MS 39204
Phone (601) 815-4775

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

421 S Stadium Cir
Jackson, MS 39216
Phone (601) 984-5211

Interoperability endpoints

  • Direct secure messaging: tbreland4436@ummc.direct-ci.com

Organizations & group practices 2

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1629177688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CLINTON CENTER DRIVE",
            "address_2": "CBO-SUITE 4300",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565610",
            "telephone_number": "601-984-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRELAND",
        "first_name": "TOBI",
        "middle_name": "L",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-03-19",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "862455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1791164",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0771257",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.