Active NPI
Tiffany Hudmon, PTA
- Physical Therapy Assistant
- Enterprise, AL
National Provider Identifier
1073739884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA4873
- Practice address
- 404 N Main St
Enterprise, AL 36330-2563 - Phone
- (334) 308-9797
- Fax
- (334) 836-2247
- NPI assigned
- Apr 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA4873 | AL | Primary |
Addresses
Primary practice location
404 N Main St
Enterprise, AL 36330-2563
Mailing address
PO Box 729
Dothan, AL 36302-0729
Phone (334) 793-2663
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA4873 | AL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073739884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 729",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363020729",
"telephone_number": "334-793-2663",
"fax_number": "334-836-2247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 N MAIN ST",
"city": "ENTERPRISE",
"state": "AL",
"postal_code": "363302563",
"telephone_number": "334-308-9797",
"fax_number": "334-836-2247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDMON",
"first_name": "TIFFANY",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AL",
"license": "PTA4873",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Enterprise, AL
- Houston Co Healthcare Authority Dba Enterprise Sleep Clinic (Enterprise Sleep Clinic)
- Houston County Healthcare Authority (Advanced Home Medical Enterprise)
- Houston County Healthcare Authority (Samc-Enterprise Medical Clinic)
- Amy Howell
- Larry Tyrone Howell, DMD
- Kristin Huebner, CCC-SLPD
- Tina Huff, RBT
- Julie Frances Hughes, C.P.N.P.
- Humbled Healing, LLC
- Tiffany Humphrey, APRN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.