Individual provider Active NPI

Tiffany Opal Livengood Reece, PA

  • Physician Assistant
  • Thomasville, NC
National Provider Identifier
1063471795
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000102880 Issued in NC
Practice address
6329 Unity St Ste a
Thomasville, NC 27360-7186
Phone
(336) 793-2518
Fax
(336) 793-9589
NPI assigned
Mar 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000102880 NC Primary

Addresses

Primary practice location

6329 Unity St Ste a
Thomasville, NC 27360-7186

Mailing address

PO Box 604050
Charlotte, NC 28260-4050

Other practice location 1

186 Kimel Park Dr
Winston-Salem, NC 27103-6946
Phone (336) 277-2000

Other practice location 2

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-8383

Other identifiers 1

IdentifierTypeStateIssuer
1285682310OtherNCWSCA GRP NPI #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address treece140616@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050217000367 NC Practitioner - Physician Assistant 3072565092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
NH-CL Clinics LLCGroup PAC ID 6305262692, 82 clinicians

Practice addresses (Care Compare)

500 Pineview Dr
Suite 205
Kernersville, NC 27284-3814
Phone (336) 329-3295

6329 Unity St
Suite a
Thomasville, NC 27360-7186
Phone (336) 793-2518

6371 Jessie LN
Clemmons, NC 27012-9887
Phone (336) 740-9060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000102880NCMDPhysician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1063471795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604050",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6329 UNITY ST STE A",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273607186",
            "telephone_number": "336-793-2518",
            "fax_number": "336-793-9589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "186 Kimel Park Dr",
            "address_purpose": "LOCATION",
            "city": "Winston-Salem",
            "state": "NC",
            "postal_code": "271036946",
            "country_code": "US",
            "telephone_number": "336-277-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Silas Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033013",
            "country_code": "US",
            "telephone_number": "336-718-8383",
            "fax_number": "336-718-9622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REECE",
        "first_name": "TIFFANY",
        "middle_name": "OPAL LIVENGOOD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "000102880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WSCA GRP NPI #",
            "identifier": "1285682310",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "treece140616@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "186 Kimel Park Dr",
            "city": "Winston-Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Thomasville, NC

Sources for this page

Verify at the official NPI Registry.