Tiffany Boyd, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

905458 Issued in MS

Practice address

1161 Church Road W
Southaven, MS 38671

Phone

(662) 253-1067

Fax

(662) 253-1068

NPI assigned

Aug 15, 2022

Last updated

Aug 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559
  Medicare reassignment Care Compare group
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  MS, Multi-Specialty

  Medicare reassignment NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1992433163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 CHURCH ROAD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "38671",
            "telephone_number": "662-253-1067",
            "fax_number": "662-253-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 CHURCH ROAD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "38671",
            "telephone_number": "662-253-1067",
            "fax_number": "662-253-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "TIFFANY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Gale Bouchillon
• Jade Boulton, APRN
• Aaron Tate Boyd, PA
• Justin Boyd
• Kelsey Boyd, LMSW
• Wesley Boyd, PA
• Jarad Joseph Braddy, D.D.S.
• John Mark Bradford, R.PH.
• Bradley S Thompson Family Limited Partnership No One
• Mackenzie Eryn Brannan, PT

• Family Nurse Practitioner in Southaven, MS
• Providers in Southaven, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.