ADRIENNE KELSEY TADLOCK CPNP-AC
NPI 1033870605
Nurse Practitioner - Pediatrics in Jackson, MS

Q: What is Adrienne Tadlock's NPI number?

The NPI number for Adrienne Tadlock is 1033870605. It was assigned to this individual provider in the NPPES registry on January 6, 2022.

Q: What is Adrienne Tadlock's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Adrienne Tadlock was last updated on January 13, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 06, 2022PECOS EnrolledAccepts Medicare Assignment

2500 N STATE ST, JACKSON, MS 39216(601) 984-1000 Get Directions Write a Review

NPPES record last updated: January 13, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 13, 2022, Jan 6, 2022 (2 updates tracked since 2022).

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About Adrienne Kelsey Tadlock Cpnp-ac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADRIENNE KELSEY TADLOCK CPNP-AC (NPI 1033870605) is an individual pediatrics provider in Jackson, Mississippi, licensed in Mississippi (905076) and active in the NPI registry since January 2022. She is enrolled in Medicare PECOS and is a graduate of University Of Mississippi School Of Medicine (2021).

NPPES Registry Identity

NPI1033870605

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameADRIENNE KELSEY TADLOCKCredential: CPNP-AC

Location Address2500 N STATE STJackson, MS 39216-4500

Mailing Address6026 Chapel Hill RdDecatur, MS 39327-9263 · (601) 692-5036

Phone(601) 984-1000

Sole ProprietorNo

Medical School CMSUniversity Of Mississippi School Of MedicineGraduated 2021

Enumeration DateJanuary 6, 2022

Last NPPES UpdateJanuary 13, 20222 updates tracked since enumeration

NPPES CertifiedJanuary 13, 2022

✔ NPI 1033870605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in MS · 905076

2500 N STATE ST, Jackson, MS 39216

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Adrienne Kelsey Tadlock Cpnp-ac is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7214322023

PECOS Enrollment IDI20220314002104

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39216 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAMAR DAVIS II M.D.

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