Individual provider Active NPI

Tiffany Leister, N.P.

  • Family Nurse Practitioner
  • Oxford, MS
National Provider Identifier
1629302823
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
871899 Issued in MS
Practice address
2209 Jefferson Davis Dr
Oxford, MS 38655-5221
Phone
(662) 281-1115
Fax
(662) 281-1113
NPI assigned
Sep 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 871899 MS Primary
Nurse Practitioner 363L00000X R871899 MS

Addresses

Primary practice location

2209 Jefferson Davis Dr
Oxford, MS 38655-5221

Mailing address

1300 Access Rd Ste 400
Oxford, MS 38655-5211
Phone (662) 281-1115

Other practice location 1

1300 Access Rd Ste 400
Oxford, MS 38655-5211
Phone (662) 281-1115

Other identifiers 1

IdentifierTypeStateIssuer
02876000MedicaidMS

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
I20100303000618 MS Practitioner - Nurse Practitioner 1850436767 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stern Cardiovascular Foundation, IncGroup PAC ID 8123200540, 111 clinicians
Urgent Care Clinic of OxfordGroup PAC ID 9537109491, 7 clinicians
Oxford After Hours Clinic, LLCGroup PAC ID 3476733890, 6 clinicians
Stern Cardiovascular Center, PAGroup PAC ID 2860390275, 126 clinicians

Practice addresses (Care Compare)

100 Baptist Memorial Cir
Suite 201
Oxford, MS 38655-4476
Phone (901) 271-1000

1100 Belk Blvd
Oxford, MS 38655-5242
Phone (662) 232-8100

1487 Belk Blvd
Oxford, MS 38655-5371
Phone 66223410902

1929 University Ave
Oxford, MS 38655-4113
Phone (662) 236-2232

2209 Jefferson Davis Dr
Oxford, MS 38655-5221
Phone (901) 271-4187

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R871899MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Clinic of Oxford Nurse Practitioner CurrentSince Apr 1, 2014 Accepting new patients
Stern Cardiovascular Center, PA CurrentSince Jan 3, 2026 Accepting new patients
Stern Cardiovascular Foundation, Inc CurrentSince Jan 1, 2020 Accepting new patients

Locations

825 W Monroe St
Grenada, MS 38901
Phone (662) 227-9091

200 State Highway 30 W
New Albany, MS 38652
Phone (601) 534-7631

1487 Belk Blvd
Oxford, MS 38655
Phone (601) 234-1090

2209 Jefferson Davis Dr
Oxford, MS 38655
Phone (662) 236-1352

100 Baptist Memorial Cir
Ste 201
Oxford, MS 38655
Phone (662) 574-5293

Interoperability endpoints

  • Direct secure messaging: tiffanyleister@stern.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/IABFAA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1629302823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 ACCESS RD STE 400",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555211",
            "telephone_number": "662-281-1115",
            "fax_number": "662-281-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 JEFFERSON DAVIS DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555221",
            "telephone_number": "662-281-1115",
            "fax_number": "662-281-1113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Access Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386555211",
            "country_code": "US",
            "telephone_number": "662-281-1115",
            "fax_number": "662-281-1113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEISTER",
        "first_name": "TIFFANY",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-22",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "871899",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R871899",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02876000",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.