Individual provider Active NPI

Tiffany A Yocum, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Owensboro, KY
National Provider Identifier
1114437738
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3011937 Issued in KY
Practice address
2211 Mayfair Dr Ste 409
Owensboro, KY 42301-4570
Phone
(270) 417-7980
Fax
(270) 417-7989
NPI assigned
Oct 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3011937 KY Primary

Addresses

Primary practice location

2211 Mayfair Dr Ste 409
Owensboro, KY 42301-4570

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tyocum84467@direct.owensborohealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20180110000729 KY Practitioner - Nurse Practitioner 2163781550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2211 Mayfair Dr
Owensboro, KY 42301-4569

2211 Mayfair Dr
Suite 409
Owensboro, KY 42301-4570
Phone (270) 417-7980

PO Box
Suite 23229
Owensboro, KY 42304-3229

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group, Inc Psychiatric/Mental Health CurrentSince Jan 8, 2018 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Jan 8, 2018 Accepting new patients

Locations

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

2211 Mayfair Dr
Ste 409
Owensboro, KY 42301
Phone (270) 417-7980

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1114437738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 MAYFAIR DR STE 409",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423014570",
            "telephone_number": "270-417-7980",
            "fax_number": "270-417-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOCUM",
        "first_name": "TIFFANY",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3011937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tyocum84467@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "2211 Mayfair Dr Ste 409",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423014570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.