Tiara Annette Perez, C.A.D.C.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

15005 Issued in IA

Practice address

310 W. Main St.
Ottumwa, IA 52501

Phone

(641) 683-6747

Fax

(641) 683-6317

NPI assigned

May 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Tiara Annette Formaro Former name

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 and National Provider Directory roles.

• Southern Iowa Economic Development Assoc

  • Addiction (Substance Use Disorder) Counselor
  • Ottumwa, IA
  • NPI 1396711768
  NPD (past)
• United Community Services, Inc.

  • Point of Service
  • West Des Moines, IA
  • NPI 1609998137
  NPD (past)

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1164959854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 658",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "52501",
            "telephone_number": "641-683-6747",
            "fax_number": "641-683-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W. MAIN ST.",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "52501",
            "telephone_number": "641-683-6747",
            "fax_number": "641-683-6317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "TIARA",
        "middle_name": "ANNETTE",
        "name_prefix": "Mrs.",
        "credential": "C.A.D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "15005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIARA",
            "last_name": "FORMARO",
            "middle_name": "ANNETTE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristina Payne
• Pediatric Associates of Ottumwa, P.C.
• Brenda Sue Peiffer Coram, OTR/L
• Pella Regional Health Center
• Pella Regional Health Center
• Sondra Philips, FNP-BC,
• Cynthia L Jennings Phillips, DDS
• Physiotherapy Assoicates, Inc.
• Payne M Pleima, CADC
• Ashley M Pooker, OTR

• Addiction (Substance Use Disorder) Counselor in Ottumwa, IA
• Providers in Ottumwa, IA by specialty
• Addiction (Substance Use Disorder) Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; 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.