Tyesha Pringle, NP
Individual provider Active NPI Nurse Practitioner · Meridian, MS
NPI 1982425666 · NPPES record last updated Dec 2, 2024
Key facts
- NPI
- 1982425666
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 918302 (MS)
- Practice address
- 500 Saddlebrook Dr
Meridian, MS 39305-9548 - Phone
- (601) 616-9008
- NPI assigned
- Oct 24, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fast Pace Mississippi PLLC
Practice addresses (Care Compare)
296 Eastside Dr
Newton, MS 39345-8036
Phone (601) 228-8985
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250110000821 | MS | Practitioner - Nurse Practitioner | 2264960889 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 918302 | MS | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Mississippi, PLLC | Nurse Practitioner | Current |
Accepting new patients |
| Upperline Healthcare, PC | Nurse Practitioner | Current |
Accepting new patients |
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Fast Pace Mississippi, PLLC | Current |
Accepting new patients |
Locations
1061 Highway 35 S
Forest, MS 39074
Phone (601) 541-4310
7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661
296 Eastside Dr
Newton, MS 39345
Phone (601) 228-8985
517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 918302 | MS | Yes |
| Primary Care Nurse Practitioner | 363LP2300X | 906923 | MS |
Addresses
Primary practice location
500 Saddlebrook Dr
Meridian, MS 39305-9548
Mailing address
500 Saddlebrook Dr
Meridian, MS 39305-9548
Phone (601) 616-9008
NPI Registry JSON
{
"created_epoch": "1729728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733097600000",
"number": "1982425666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 SADDLEBROOK DR",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393059548",
"telephone_number": "601-616-9008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 SADDLEBROOK DR",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393059548",
"telephone_number": "601-616-9008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRINGLE",
"first_name": "TYESHA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-24",
"last_updated": "2024-12-02",
"certification_date": "2024-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "918302",
"primary": true
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "MS",
"license": "906923",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, MS
- Ana Ecaterina Primeaux
- Terineshia Prince
- Jessica Rutledge Princell
- Candace Pringle-Welch
- Derrick Pringle
- Christina N. Pritchard
- Layanna Pritchard
- Jaquella Pritchett
- Professional Therapy Services Inc
- Progress Place LLC
All providers in Meridian, MS · Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.