Miss Tiffany Shannon Ray, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Horn Lake, MS

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Miss Tiffany Shannon Ray, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Horn Lake, Mississippi. She graduated from nursing school in 2005 and has 19 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Poplar Avenue Clinic, Pllc, Gastroenterology Center Of The Midsouth Pllc, Willow Anesthesia Services, Llc, Poplar Avenue Clinic, Pllc and her current practice location is 6410 Walnut Grove Rd, Horn Lake, Mississippi. You can reach out to her office (for appointments etc.) via phone at (901) 652-0880.

Miss Tiffany Shannon Ray is licensed to practice in Mississippi (license number R864509) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1114097615.

Contact Information

Miss Tiffany Shannon Ray, CRNA
6410 Walnut Grove Rd,
Horn Lake, MS 38637-2023
(901) 652-0880
Not Available

Map and Direction




Provider's Profile

Full NameMiss Tiffany Shannon Ray
GenderFemale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience19 Years
Location6410 Walnut Grove Rd, Horn Lake, Mississippi
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Miss Tiffany Shannon Ray graduated from nursing school in 2005
  NPI Data:
  • NPI Number: 1114097615
  • Provider Enumeration Date: 11/09/2006
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 1153358072
  • Enrollment ID: I20050722000275

Medical Identifiers

Medical identifiers for Miss Tiffany Shannon Ray such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114097615NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered R864509 (Mississippi)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Poplar Avenue Clinic, Pllc004255245713
Gastroenterology Center Of The Midsouth Pllc4880619824138
Willow Anesthesia Services, Llc923427918328
Poplar Avenue Clinic, Pllc004255245713

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Miss Tiffany Shannon Ray allows following entities to bill medicare on her behalf.
Entity NameGastroenterology Center Of The Midsouth Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1417932492
PECOS PAC ID: 4880619824
Enrollment ID: O20051010000483
Entity NameWillow Anesthesia Services, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205169521
PECOS PAC ID: 9234279183
Enrollment ID: O20091228000308
Entity NamePoplar Avenue Clinic, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124588793
PECOS PAC ID: 0042552457
Enrollment ID: O20190506001682
Entity NameSoms Anesthesia, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063010189
PECOS PAC ID: 9133531254
Enrollment ID: O20201215000881

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Tiffany Shannon Ray is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Miss Tiffany Shannon Ray, CRNA
6410 Walnut Grove Rd,
Horn Lake, MS 38637-2023

Ph: (901) 652-0880		Miss Tiffany Shannon Ray, CRNA
6410 Walnut Grove Rd,
Horn Lake, MS 38637-2023

Ph: (901) 652-0880

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Horn Lake, MS


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.