Individual provider Active NPI

Tannisha Monique Loggins, NURSE PRACTITIONER

  • Nurse Practitioner
  • Southaven, MS
National Provider Identifier
1669955423
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
902664 Issued in MS
Practice address
7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone
(662) 772-2980
Fax
(662) 772-2960
NPI assigned
Sep 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 902664 MS Primary

Addresses

Primary practice location

7601 Southcrest Pkwy
Southaven, MS 38671-4739

Mailing address

965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181130000796 MS Practitioner - Nurse Practitioner 1153592233 Reassigns benefits to 2 organizations
I20240424003388 TN Practitioner - Nurse Practitioner 1153592233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenbrook Physician Services, LLCGroup PAC ID 5597267427, 70 clinicians

Practice addresses (Care Compare)

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-2130

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrook Physician Services, LLC Nurse Practitioner CurrentSince Oct 1, 2025 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Dec 17, 2018 Accepting new patients
Baptist Memorial Medical Group Inc Nurse Practitioner CurrentSince Dec 17, 2018 Accepting new patients

Locations

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

965 Ridge Lake Blvd
Ste 103
Memphis, TN 38120
Phone (901) 227-3221

Interoperability endpoints

  • Direct secure messaging: tloggins30241@direct.bmhcc.org

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.

Hospital & facility affiliations 1

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": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1669955423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 SOUTHCREST PKWY",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714739",
            "telephone_number": "662-772-2980",
            "fax_number": "662-772-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGGINS",
        "first_name": "TANNISHA",
        "middle_name": "MONIQUE",
        "credential": "NURSE  PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-07",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "902664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.