Individual provider Active NPI

Teresa L Fitts, CFNP

  • Nurse Practitioner
  • Pontotoc, MS
National Provider Identifier
1861508558
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R697605 Issued in MS
Practice address
1079 Highway 342
Pontotoc, MS 38863-8973
Phone
(662) 488-1257
NPI assigned
Aug 22, 2006
Last updated
Jan 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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 R697605 MS Primary

Addresses

Primary practice location

1079 Highway 342
Pontotoc, MS 38863-8973

Mailing address

140 Burke Calhoun City Rd
Calhoun City, MS 38916-9690
Phone (662) 488-1257

Other identifiers 1

IdentifierTypeStateIssuer
00124056MedicaidMS

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
I20060208000811 MS Practitioner - Nurse Practitioner 3375558554 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

112 Medical Arts Dr
Calhoun City, MS 38916-9721
Phone (662) 628-1274

140 Burke Calhoun City Rd
Calhoun City, MS 38916-9690
Phone (662) 628-6611

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Hospital-Calhoun Inc CurrentSince Jan 2, 2018 Accepting new patients
Comprehensive Hospitalists of Ms, LLC CurrentSince Dec 26, 2016 Accepting new patients
Comprehensive Hospitalists of Ms, LLC CurrentSince Dec 26, 2016 Accepting new patients
Baptist Memorial Hospital-Calhoun Inc Current Accepting new patients
Acute Care & Family Clinic of Pontotoc Nurse Practitioner PastSince May 1, 2004 Accepting new patients

Locations

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

112 Medical Arts Dr
Calhoun City, MS 38916
Phone (662) 628-1274

1100 Belk Blvd
Oxford, MS 38655
Phone (662) 636-1000

140 Burke Calhoun City Rd
Slate Spring, MS 38916
Phone (662) 628-6611

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1861508558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BURKE CALHOUN CITY RD",
            "city": "CALHOUN CITY",
            "state": "MS",
            "postal_code": "389169690",
            "telephone_number": "662-488-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1079 HIGHWAY 342",
            "city": "PONTOTOC",
            "state": "MS",
            "postal_code": "388638973",
            "telephone_number": "662-488-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITTS",
        "first_name": "TERESA",
        "middle_name": "L",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R697605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124056",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontotoc, MS

Sources for this page

Verify at the official NPI Registry.