Individual provider Active NPI

Tiffany Meadows

  • Physical Therapist
  • Russellville, AR
National Provider Identifier
1063535409
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2688 Issued in AR
Practice address
1301 Russell Rd
Russellville, AR 72802-4320
Phone
(479) 967-2316
Fax
(479) 967-3639
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2688 AR Primary

Addresses

Primary practice location

1301 Russell Rd
Russellville, AR 72802-4320

Mailing address

P.O. Drawer 2109
Russellville, AR 72811-2109
Phone (479) 967-2322

Other practice location 1

1500 Cheri Whitlock
Siloam Springs, AR 72761-4220
Phone (479) 524-2456

Other identifiers 1

IdentifierTypeStateIssuer
152099721MedicaidAR

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

Practice roles

OrganizationSpecialtyStatusNew patients
Friendship Community Care Inc. PastSince Mar 19, 2024 Accepting new patients

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1063535409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. DRAWER 2109",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728112109",
            "telephone_number": "479-967-2322",
            "fax_number": "479-967-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 RUSSELL RD",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728024320",
            "telephone_number": "479-967-2316",
            "fax_number": "479-967-3639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Cheri Whitlock",
            "address_purpose": "LOCATION",
            "city": "Siloam Springs",
            "state": "AR",
            "postal_code": "727614220",
            "country_code": "US",
            "telephone_number": "479-524-2456",
            "fax_number": "479-373-1129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEADOWS",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "2688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152099721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.