Individual provider Active NPI

Tiffiney L Lavergne, CRNA

  • Certified Registered Nurse Anesthetist
  • McComb, MS
National Provider Identifier
1861653941
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R873703 Issued in MS
Practice address
215 Marion Ave
McComb, MS 39648-2705
Phone
(601) 249-1183
Fax
(601) 249-1709
NPI assigned
Jun 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R873703 MS Primary

Addresses

Primary practice location

215 Marion Ave
McComb, MS 39648-2705

Mailing address

215 Marion Ave
McComb, MS 39648-2705
Phone (601) 249-1183

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150129001482 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698849891 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lallie Kemp Medical CtrGroup PAC ID 0345238903, 38 clinicians

Practice addresses (Care Compare)

52579 Hwy 51 S
Independence, LA 70443-2231
Phone (985) 878-1349

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R873703MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2015 Accepting new patients
Total Anesthesia Care STPH, LLC CurrentSince Jan 12, 2015 Accepting new patients
Lallie Kemp Medical Ctr Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2018 Accepting new patients
Lallie Kemp Medical Ctr CurrentSince Mar 1, 2018 Accepting new patients

Locations

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

120 Innwood Dr
Covington, LA 70433

42570 S Airport Rd
Hammond, LA 70403
Phone (985) 510-6135

52579 Highway 51 S
Independence, LA 70443
Phone (985) 878-1349

1100 Andre St
Ste 300
New Iberia, LA 70563
Phone (337) 364-9225

Organizations & group practices 4

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 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": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1861653941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482705",
            "telephone_number": "601-249-1183",
            "fax_number": "601-249-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482705",
            "telephone_number": "601-249-1183",
            "fax_number": "601-249-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVERGNE",
        "first_name": "TIFFINEY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R873703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.