TANISHA MARTIN
NPI 1649753161
Nurse Practitioner - Psychiatric/Mental Health in Southaven, MS

Q: What is Tanisha Martin's NPI number?

The NPI number for Tanisha Martin is 1649753161. It was assigned to this individual provider in the NPPES registry on September 11, 2018.

Q: What is Tanisha Martin's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Tanisha Martin was last updated on September 11, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 11, 2018PECOS EnrolledAccepts Medicare Assignment

8626 AIRWAYS BLVD, SOUTHAVEN, MS 38671(662) 832-0302 Get Directions Write a Review

NPPES record last updated: September 11, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Tanisha Martin NPPES

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

TANISHA MARTIN (NPI 1649753161) is an individual psychiatric/mental health provider in Southaven, Mississippi, licensed in Mississippi (902907) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1649753161

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameTANISHA MARTIN

Location Address8626 AIRWAYS BLVDSouthaven, MS 38671-2603

Mailing Address108 Bailey Patricia AveOxford, MS 38655-7336 · (662) 832-0302

Phone(662) 832-0302

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateSeptember 11, 2018

✔ NPI 1649753161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in MS · 902907

8626 AIRWAYS BLVD, Southaven, MS 38671

Open in Google Maps ↗

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

Tanisha Martin 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 ID9032462437

PECOS Enrollment IDI20181101001967

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 38671 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.

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.

DR. MARILYN S SNOW PH.D. ,LPC

Counselor (Professional)