Individual provider Active NPI

Tiffany Beaumont Coleman, CRNP

  • Acute Care Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1124767090
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R207784 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1590
Phone
(410) 328-3737
NPI assigned
May 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R207784 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1590

Mailing address

22 S Greene St
Baltimore, MD 21201-1590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20251105000899 MD Order and Referring Only - Nurse Practitioner 2769972173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R207784MDMDAcute Care Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: tcoleman84589@direct.umm.edu

NPI Registry JSON

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1124767090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011590",
            "telephone_number": "410-328-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "TIFFANY",
        "middle_name": "BEAUMONT",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R207784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.