Tyshianna B Edwards, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT-3947 Issued in MS

Practice address

1751 Dancy Blvd Ste 2
Horn Lake, MS 38637-1916

Phone

(901) 292-5313

Fax

(901) 867-1603

NPI assigned

Jul 29, 2022

Last updated

Jul 29, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aegis Group Practice LLC

  • Physical Therapist
  • Ridgeland, MS
  • NPI 1881271302

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Indian Harbour Beach, FL
  • NPI 1932072030

  Occupational Therapist

  NPD
• Pediatric Therapy Service

  • Pediatric Physical Therapist
  • Arlington, TN
  • NPI 1205099934
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1841926086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11315 MCCORMICK RD",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "380029512",
            "telephone_number": "901-461-7633",
            "fax_number": "901-867-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 DANCY BLVD STE 2",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386371916",
            "telephone_number": "901-292-5313",
            "fax_number": "901-867-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "TYSHIANNA",
        "middle_name": "B",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT-3947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelly Curtis, PHARMD
• Christine Davidson, PHARMD
• Dental Professionals of Mississippi, P.C. (Dental Care at The Fountains)
• Desoto Community Care Center LLC (Landmark of Desoto)
• Gregory Kyle Dixon, GREGORY DIXON
• Lanique Ervin, LPC
• Essential Health & Wellness Clinic P.a.
• Jenna Evers
• Family & Urgent Care Clinic
• Diane A Ferguson, MD

• Occupational Therapist in Horn Lake, MS
• Providers in Horn Lake, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.