Individual provider Active NPI

Tanika Michelle Gray, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Starkville, MS
National Provider Identifier
1669164935
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
905999 Issued in MS
Practice address
12183 Ms Highway 182 Ste 108
Starkville, MS 39759-1653
Phone
(662) 268-7100
Fax
(662) 268-6080
NPI assigned
May 24, 2023
Last updated
Apr 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 905999 MS Primary

Addresses

Primary practice location

12183 Ms Highway 182 Ste 108
Starkville, MS 39759-1653

Mailing address

PO Box 520
Marion, MS 39342-0520
Phone (662) 268-7100

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
I20230717003676 MS Practitioner - Nurse Practitioner 0042670457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Region Seven Mental Health Intellectual Disabilities CommGroup PAC ID 3072531953, 12 clinicians

Practice addresses (Care Compare)

302 N Jackson St
Starkville, MS 39759-2504
Phone (601) 323-9261

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
905999MSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Region Seven Mental Health Intellectual Disabilities Comm CurrentSince Sep 1, 2024 Accepting new patients
Region Seven Mental Health Intellectual Disabilities Comm CurrentSince Jun 1, 2023 Accepting new patients
State of Mind Psychiatry, LLC Psychiatric/Mental Health CurrentSince Jun 6, 2026 Accepting new patients

Locations

12183 MS Highway 182
Ste 108
Starkville, MS 39759
Phone (662) 268-7100

302 N Jackson St
Starkville, MS 39759
Phone (662) 323-9261

222 Mary Holmes Dr
West Point, MS 39773
Phone (662) 295-6433

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, 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": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1669164935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520",
            "city": "MARION",
            "state": "MS",
            "postal_code": "393420520",
            "telephone_number": "662-268-7100",
            "fax_number": "601-268-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12183 MS HIGHWAY 182 STE 108",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397591653",
            "telephone_number": "662-268-7100",
            "fax_number": "662-268-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "TANIKA",
        "middle_name": "MICHELLE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-24",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "905999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Starkville, MS

Sources for this page

Verify at the official NPI Registry.