Individual provider Active NPI

Tiffany Elise Eastburn

  • Certified Registered Nurse Anesthetist
  • Little Rock, AR
National Provider Identifier
1194284364
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
120681 Issued in AR
Practice address
9601 Baptist Health Dr
Little Rock, AR 72205-6321
Phone
(501) 202-2093
Fax
(501) 202-6316
NPI assigned
Mar 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Certified Registered Nurse Anesthetist 367500000X 120681 AR Primary

Addresses

Primary practice location

9601 Baptist Health Dr
Little Rock, AR 72205-6321

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 812-7207

Other names 1

  • Tiffany Elise Robinson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190813001284 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678800786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health Group 645 clinicians

Practice addresses (Care Compare)

1555 Exchange Ave
Arkansas Health Group Anesthesia
Conway, AR 72032-7824
Phone (501) 202-2093

Hospital & facility affiliations

  • Baptist Health Medical Center- Conway Hospital, Conway, AR, CCN 040154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group CurrentSince Jun 24, 2019 Accepting new patients
Arkansas Health Group CurrentSince Jun 24, 2019 Accepting new patients

Locations

1555 Exchange Ave
Conway, AR 72032
Phone (501) 202-2300

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

Organizations & group practices 2

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1194284364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-812-7207",
            "fax_number": "501-812-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BAPTIST HEALTH DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056321",
            "telephone_number": "501-202-2093",
            "fax_number": "501-202-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTBURN",
        "first_name": "TIFFANY",
        "middle_name": "ELISE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "120681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "ROBINSON",
            "middle_name": "ELISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.