Individual provider Active NPI

Tiffany M Mattox-Rubin, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Southaven, MS
National Provider Identifier
1700373115
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
30562 Issued in TN
Practice address
5699 Getwell Rd
Southaven, MS 38672-7312
Phone
(662) 205-0098
NPI assigned
Apr 20, 2018
Last updated
Oct 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95022775 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 904963 MS
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 30562 TN Primary

Addresses

Primary practice location

5699 Getwell Rd
Southaven, MS 38672-7312

Mailing address

PO Box 68
Tupelo, MS 38802-0068
Phone (662) 584-5097

Other practice location 1

302 S Spring St
Tupelo, MS 38804-4822
Phone (662) 205-0098

Other practice location 2

4985 Forest Hill Rd S
Olive Branch, MS 38654-6008
Phone (901) 282-5531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TN, MS3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20221227002283 CA Practitioner - Nurse Practitioner 5890165302 Reassigns benefits to 2 organizations
I20230926000610 TN Practitioner - Nurse Practitioner 5890165302 Reassigns benefits to 1 organization
I20260223001010 MS Practitioner - Nurse Practitioner 5890165302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heale Counseling LLCGroup PAC ID 7416316880, 32 clinicians

Practice addresses (Care Compare)

5699 Getwell Rd
BLDG F5
Southaven, MS 38672-7311
Phone (662) 205-0098

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30562TNMDPediatrics Physician
904963MSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heale Counseling, LLC Psychiatric/Mental Health CurrentSince Jan 7, 2026 Accepting new patients
Strong Foundation Behavioral Health Clinic Psychiatric/Mental Health CurrentSince Aug 20, 2023 Accepting new patients
Open Door Community Health Centers CurrentSince Sep 23, 2022 Accepting new patients
Mellow Medical Inc a Professional Corporation CurrentSince Apr 13, 2023 Accepting new patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers CurrentSince Sep 23, 2022 Accepting new patients
Mid South First Care Psychiatric/Mental Health CurrentSince Jun 21, 2022 Accepting new patients

Locations

1275 8th St
Arcata, CA 95521

770 10th St
Arcata, CA 95521
Phone (707) 826-8610

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (833) 427-3566

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

5699 Getwell Rd
Southaven, MS 38672
Phone (662) 205-0098

5699 Getwell Rd
Bldg F5
Southaven, MS 38672
Phone (662) 205-0098

302 S Spring St
Tupelo, MS 38804
Phone (662) 205-0098

542 Uptown Sq
Murfreesboro, TN 37129
Phone (615) 203-5024

135 W Jackson Ave
Ripley, TN 38063
Phone (901) 403-0480

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25874/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tiffany.mattoxrubin.p1@direct.omnifamilyhealth.nextgenshare.com

Organizations & group practices 7

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": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1700373115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388020068",
            "telephone_number": "662-584-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5699 GETWELL RD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386727312",
            "telephone_number": "662-205-0098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 S Spring St",
            "address_purpose": "LOCATION",
            "city": "Tupelo",
            "state": "MS",
            "postal_code": "388044822",
            "country_code": "US",
            "telephone_number": "662-205-0098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4985 Forest Hill Rd S",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386546008",
            "country_code": "US",
            "telephone_number": "901-282-5531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTOX-RUBIN",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95022775",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "904963",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "30562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.