Individual provider Active NPI

Nancy Nanette Tienhaara, M.S, ATC L, EMT

  • Specialist
  • Lauderdale Lakes, FL
National Provider Identifier
1184664682
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
AL1661 Issued in FL
Practice address
4850 W Oakland Park Blvd
Lauderdale Lakes, FL 33313-7268
Phone
(954) 731-7440
Fax
(954) 731-7675
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X AL1661 FL Primary

Addresses

Primary practice location

4850 W Oakland Park Blvd
Lauderdale Lakes, FL 33313-7268

Mailing address

9340 NW 33Rd PL
Sunrise, FL 33351-7123
Phone (954) 747-8680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Emergency Medical Technician, Master of Science

State licenses

LicenseStateTypeSpecialty
AL1661FLMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184664682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9340 NW 33RD PL",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333517123",
            "telephone_number": "954-747-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137268",
            "telephone_number": "954-731-7440",
            "fax_number": "954-731-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIENHAARA",
        "first_name": "NANCY",
        "middle_name": "NANETTE",
        "name_prefix": "Mrs.",
        "credential": "M.S, ATC L, EMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "AL1661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.