Individual provider Active NPI

Tiffanie R Richard

  • Personal Care Attendant
  • Bastrop, TX
National Provider Identifier
1104626423
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
38017092 Issued in NE
Practice address
1141 Catfish LN
Bastrop, TX 78602-2328
Phone
(531) 777-8987
Fax
(531) 888-8655
NPI assigned
Mar 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chore Provider 372500000X 38017092 NE
Adult Companion 372600000X 38017092 NE
Personal Care Attendant 3747P1801X 38017092 NE Primary

Addresses

Primary practice location

1141 Catfish LN
Bastrop, TX 78602-2328

Mailing address

1141 Catfish LN
Bastrop, TX 78602-2328
Phone (531) 777-8987

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
38017092NEMDPersonal Care Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Goddess Oshun Home Health Care LLC CurrentSince Jul 13, 2025 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": "1742169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1104626423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 CATFISH LN",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786022328",
            "telephone_number": "531-777-8987",
            "fax_number": "531-888-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 CATFISH LN",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786022328",
            "telephone_number": "531-777-8987",
            "fax_number": "531-888-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "TIFFANIE",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NE",
            "license": "38017092",
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NE",
            "license": "38017092",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NE",
            "license": "38017092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.