Tifane S Chambers

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5017530 Issued in NC

Practice address

516 Union Church Rd
Carthage, NC 28327-7648

Phone

(910) 391-6509

NPI assigned

Sep 2, 2022

Last updated

Dec 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fresh Start Family Behavioral Wellness, PLLC

  • Community/Behavioral Health Agency
  • Cameron, NC
  • NPI 1851179865
  NPD (past) Authorized official

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701561600000",
    "number": "1154042604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 UNION CHURCH RD",
            "city": "CARTHAGE",
            "state": "NC",
            "postal_code": "283277648",
            "telephone_number": "910-391-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 UNION CHURCH RD",
            "city": "CARTHAGE",
            "state": "NC",
            "postal_code": "283277648",
            "telephone_number": "910-391-6509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Gilchrist Rd",
            "address_purpose": "LOCATION",
            "city": "Cameron",
            "state": "NC",
            "postal_code": "283269453",
            "country_code": "US",
            "telephone_number": "910-391-6509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "TIFANE",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2023-12-03",
        "certification_date": "2023-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "CHAM-MR350",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5017530",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NC",
            "license": "CHAM-MR350",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Langley DDS PLLC (Buggy Town Dental)
• David Brill, RPH
• Roberta Kathleen Britt, BSN,RN
• Carthage Family Care PA
• Carthage Healthcare Inc. (Pinelake Health & Rehab)
• Charles M. Guizzotti, D.D.S., P.a.
• Katie Irene Chisolm, IBCLC
• Krystal Cornish
• County of Moore (Moore County Health Department)
• County of Moore (Moore County EMS)

• Psychiatric/Mental Health Nurse Practitioner in Carthage, NC
• Providers in Carthage, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2023; 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.