Tiffani Lee Bohm, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

232513-30 Issued in WI

Practice address

513 E Green Bay St Apt 3
Shawano, WI 54166-2531

Phone

(920) 598-1112

NPI assigned

Jun 22, 2017

Last updated

Jul 21, 2022By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174043947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 E GREEN BAY ST APT 3",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662531",
            "telephone_number": "920-598-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 E GREEN BAY ST APT 3",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662531",
            "telephone_number": "920-598-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHM",
        "first_name": "TIFFANI",
        "middle_name": "LEE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "232513-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kavit Lache Beyersdorf, OD
• Bio-Medical Applications of Wisconsin Inc (Fresenius Medical Care Shawano)
• Birch Hill Care Center LLC (Atrium Post Acute Care of Shawano at Birch Hill)
• David Randall Block, LCSW
• Judith A Blum, O.T.R.
• Robert Joseph Bohr Jr.
• Cynthia M Bohringer
• Shelby Borchers
• Julia Bowman
• Amy Elizabeth Bozzacco, LPC

• Registered Nurse in Shawano, WI
• Providers in Shawano, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.