Individual provider Active NPI

Tiffany M Kinnison, APRN

  • Adult Health Clinical Nurse Specialist
  • Topeka, KS
National Provider Identifier
1174115182
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
79985 Issued in KS
Practice address
634 SW Mulvane St Ste 405
Topeka, KS 66606-1678
Phone
(785) 295-8470
NPI assigned
Feb 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 2021003528 KS
Adult Health Clinical Nurse Specialist 364SA2200X 79985 KS Primary

Addresses

Primary practice location

634 SW Mulvane St Ste 405
Topeka, KS 66606-1678

Mailing address

6650 W 110TH St Ste 220a
Overland Park, KS 66211-1501
Phone (913) 549-3884

Other practice location 1

1130 W 4th St Ste 3204
Lawrence, KS 66044-1345
Phone (785) 505-5815

Other practice location 2

6650 W 110th St Ste 220A
Overland Park, KS 66211-1501
Phone (913) 549-3884

Other identifiers 1

IdentifierTypeStateIssuer
30004752220001MedicaidKS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tiffany.kinnison@direct.lmh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20210727003984 KS Practitioner - Nurse Practitioner 3577965789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence Physicians LLCGroup PAC ID 1951623834, 223 clinicians

Practice addresses (Care Compare)

1130 W 4TH St
3204 Lawrence Spine Care
Lawrence, KS 66044-1328
Phone (785) 505-5815

Hospital & facility affiliations

  • LMH Hospital, Lawrence, KS, CCN 170137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2021003528KSMDAdult Health Clinical Nurse Specialist
79985KSMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Topeka Physician Group, LLC CurrentSince Feb 1, 2024 Accepting new patients
Lawrence Physicians LLC CurrentSince Nov 29, 2023 Accepting new patients
Liveactive Multispecialty Physician Group LLC CurrentSince Nov 1, 2023 Accepting new patients
Lawrence Physicians LLC CurrentSince Nov 29, 2023 Accepting new patients
Topeka Physician Group, LLC CurrentSince Feb 1, 2024 Accepting new patients
Lawrence Physicians LLC Current Accepting new patients
Liveactive Primary Care, LLC PastSince Nov 1, 2023 Accepting new patients

Locations

1130 W 4th St
Ste 3204
Lawrence, KS 66044
Phone (785) 505-5815

325 Maine St
Lawrence, KS 66044
Phone (785) 505-2988

1130 W 4th St
Ste 2050
Lawrence, KS 66044
Phone (785) 505-3636

1700 SW 7th St
Topeka, KS 66606
Phone (785) 295-5310

634 SW Mulvane St
Ste 405
Topeka, KS 66606
Phone (785) 295-8470

634 SW Mulvane St
Ste 209
Topeka, KS 66606
Phone (785) 295-5330

Interoperability endpoints

  • Direct secure messaging: tiffany.kinnison@direct.lmh.org

Organizations & group practices 7

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": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1174115182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 W 110TH ST STE 220A",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111501",
            "telephone_number": "913-549-3884",
            "fax_number": "913-273-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 SW MULVANE ST STE 405",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061678",
            "telephone_number": "785-295-8470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1130 W 4th St Ste 3204",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "KS",
            "postal_code": "660441345",
            "country_code": "US",
            "telephone_number": "785-505-5815",
            "fax_number": "785-505-5278",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6650 W 110th St Ste 220A",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662111501",
            "country_code": "US",
            "telephone_number": "913-549-3884",
            "fax_number": "913-273-3343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINNISON",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "KS",
            "license": "2021003528",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "KS",
            "license": "79985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30004752220001",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tiffany.kinnison@direct.lmh.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1130 W 4th St Ste 3204",
            "city": "Lawrence",
            "state": "KS",
            "country_code": "US",
            "postal_code": "660441345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

Verify at the official NPI Registry.