Individual provider Active NPI

Tiffany Green, NP-C

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1023462884
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95003934 Issued in CA
Practice address
2653 Elm Ave
Suite 300
Long Beach, CA 90806-1652
Phone
(562) 595-7335
NPI assigned
Apr 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95003934 CA Primary

Addresses

Primary practice location

2653 Elm Ave
Suite 300
Long Beach, CA 90806-1652

Mailing address

5882 Bolsa Ave
Suite 100
Huntington Beach, CA 92649-5702
Phone (714) 890-1002

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
95003934CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oncology Hematology Consultants Medical Group, Inc. Past Accepting new patients
Oncology Hematology Consultants Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1023462884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5882 BOLSA AVE",
            "address_2": "SUITE 100",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926495702",
            "telephone_number": "714-890-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 ELM AVE",
            "address_2": "SUITE 300",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061652",
            "telephone_number": "562-595-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TIFFANY",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-19",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.