IndividualActive
Zachary Tisdale
NPI 1730048794 · Nurse Practitioner · De Kalb, MS
Zachary Tisdale is a Nurse Practitioner provider in De Kalb, MS (NPI 1730048794).
Provider details
- NPI number
- 1730048794
- Entity type
- Individual
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 907900 (MS)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
14365 Highway 16 W
De Kalb, MS 39328-7974
Phone: (769) 486-1000
Approximate (ZIP-level) locationGet directions
Mailing address
36 Melissa Loop
Petal, MS 39465-6303
Additional practice locations (1)
- 1314 19th AveMeridian, MS 39301-4116Phone: (601) 483-0011
Registry dates
- Enumerated
- 2026-01-16
- Last updated
- 2026-01-16
- Certified
- 2026-01-16
Frequently asked questions
- What is Zachary Tisdale's NPI number?
- Zachary Tisdale's National Provider Identifier (NPI) is 1730048794, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Zachary Tisdale's specialty?
- Zachary Tisdale is listed in the NPPES registry with a primary specialty of Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Zachary Tisdale located?
- Zachary Tisdale's practice location on file with NPPES is 14365 Highway 16 W, De Kalb, MS 39328-7974.
- What is Zachary Tisdale's phone number?
- The practice phone number listed in the NPPES registry for Zachary Tisdale is (769) 486-1000.
- Is Zachary Tisdale's NPI active?
- Yes — Zachary Tisdale's NPI (1730048794) is active in the NPPES registry as of the last update on 2026-01-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.