Individual provider Active NPI

Tiffaney Ross

  • Speech-Language Pathologist
  • Aurora, IL
National Provider Identifier
1003499021
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202008663 Issued in VA
Practice address
4209 Chesapeake Dr Apt 1B
Aurora, IL 60504-5146
Phone
(630) 677-8127
NPI assigned
Apr 29, 2021
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146.011850 IL
Speech-Language Pathologist 235Z00000X 2202008663 VA Primary

Addresses

Primary practice location

4209 Chesapeake Dr Apt 1B
Aurora, IL 60504-5146

Mailing address

115 E Ogden Ave Ste 105-149
Naperville, IL 60563-3103
Phone (630) 677-8127

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Aurora Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
146.011850ILMDSpeech-Language Pathologist
2202008663VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
New Start Diagnostic LLC Speech-Language Pathologist CurrentSince May 16, 2021 Accepting new patients

Locations

115 E Ogden Ave
Ste 105149
Naperville, IL 60563
Phone (630) 677-8127

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1003499021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E OGDEN AVE STE 105-149",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605633103",
            "telephone_number": "630-677-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 CHESAPEAKE DR APT 1B",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605045146",
            "telephone_number": "630-677-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "TIFFANEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.011850",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202008663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Aurora",
            "affiliation": "N",
            "endpointDescription": "Presence Learning Platform",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4209 Chesapeake Dr Apt 1B",
            "city": "Aurora",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605045146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.