Individual provider Active NPI

Tracy Lee Tiffany

  • Registered Nurse
  • Clifton Springs, NY
National Provider Identifier
1093092280
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
534295 Issued in NY
Practice address
1550 Route 488
Clifton Springs, NY 14432-9308
Phone
(315) 548-6620
Fax
(315) 548-6639
NPI assigned
Nov 16, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 534295 NY Primary

Addresses

Primary practice location

1550 Route 488
Clifton Springs, NY 14432-9308

Mailing address

1550 Route 488
Clifton Springs, NY 14432-9308
Phone (315) 548-6620

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
534295NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1093092280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 ROUTE 488",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144329308",
            "telephone_number": "315-548-6620",
            "fax_number": "315-548-6639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 ROUTE 488",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144329308",
            "telephone_number": "315-548-6620",
            "fax_number": "315-548-6639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIFFANY",
        "first_name": "TRACY",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "534295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.