Individual provider Active NPI

Tanya Melonie Litchmore-Porter, NP

  • Adult Health Nurse Practitioner
  • Greensboro, NC
National Provider Identifier
1184495632
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
298955 Issued in NC
Practice address
124 E Gate City Blvd
Greensboro, NC 27406-1457
Phone
(336) 334-5000
NPI assigned
Jan 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 298955 NC Primary

Addresses

Primary practice location

124 E Gate City Blvd
Greensboro, NC 27406-1457

Mailing address

124 E Gate City Blvd
Greensboro, NC 27406-1457
Phone (336) 334-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20250327003757 NC Practitioner - Nurse Practitioner 0446773618 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
298955NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Feb 1, 2025 Accepting new patients

Locations

555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1184495632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E GATE CITY BLVD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274061457",
            "telephone_number": "336-334-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E GATE CITY BLVD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274061457",
            "telephone_number": "336-334-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITCHMORE-PORTER",
        "first_name": "TANYA",
        "middle_name": "MELONIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "298955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.