Active NPI
Tiana Luckett
- Family Medicine Physician
- Jackson, MS
National Provider Identifier
1659220317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 919409
- Practice address
- 6295 Old Canton Rd Apt 34B
Jackson, MS 39211-2935 - Phone
- (601) 291-8872
- NPI assigned
- Jan 26, 2026
- Last updated
- Jan 26, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 919409 | MS | Primary |
Addresses
Primary practice location
6295 Old Canton Rd Apt 34B
Jackson, MS 39211-2935
Mailing address
6295 Old Canton Rd Apt 34B
Jackson, MS 39211-2935
Phone (601) 291-8872
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 919409 | MS | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1769385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769385600000",
"number": "1659220317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6295 OLD CANTON RD APT 34B",
"city": "JACKSON",
"state": "MS",
"postal_code": "392112935",
"telephone_number": "601-291-8872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6295 OLD CANTON RD APT 34B",
"city": "JACKSON",
"state": "MS",
"postal_code": "392112935",
"telephone_number": "601-291-8872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCKETT",
"first_name": "TIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-01-26",
"last_updated": "2026-01-26",
"certification_date": "2026-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "919409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.