Peggie Tisdale-Brown

Primary specialty

Social WorkerTaxonomy code 104100000X

License

8100-M Issued in AR

Practice address

1864 E Parkshore Dr Apt 11
Fayetteville, AR 72703-6268

Phone

(479) 443-4301

Fax

(479) 587-5994

NPI assigned

Mar 26, 2018

Last updated

Mar 26, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Peggie Tisdale Brown Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1053816827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-443-4301",
            "fax_number": "479-587-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1864 E PARKSHORE DR APT 11",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036268",
            "telephone_number": "479-443-4301",
            "fax_number": "479-587-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE-BROWN",
        "first_name": "PEGGIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "8100-M",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEGGIE",
            "last_name": "BROWN",
            "middle_name": "TISDALE",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gretchen Timpe, M.S., CFY-SLP
• James Charles Tinnin, D.D.S.
• James Martin Tinnin, D.D.S., M.S.D.
• Robert Preston Tinnin, DDS
• Nicole Tira, MED, LAT, ATC
• Patricia Tisdale, NP
• Victoria Tisdale, LMSW
• Tison Speech Therapy Services
• Christopher Titsworth, CNP
• Janet Lynn Titus, MD

• Social Worker in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; 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.