Individual provider Active NPI

Tiffani Rose, CNP

  • Primary Care Nurse Practitioner
  • New Albany, OH
National Provider Identifier
1255679171
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
COA.17574-NP Issued in OH
Practice address
4580 Commons Park Dr
New Albany, OH 43054-8699
Phone
(614) 710-0077
Fax
(614) 710-0077
NPI assigned
Jan 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN267314 OH
Primary Care Nurse Practitioner 363LP2300X COA.17574-NP OH Primary

Addresses

Primary practice location

4580 Commons Park Dr
New Albany, OH 43054-8699

Mailing address

4580 Commons Park Dr
New Albany, OH 43054-8699
Phone (614) 710-0727

Other identifiers 1

IdentifierTypeStateIssuer
0088547MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20151019001419 OH Practitioner - Nurse Practitioner 3476862202 Practice locations: New Albany, OH

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

New Albany, OH 43054
Phone (614) 710-0727

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN267314OHMDRegistered Nurse
COA.17574-NPOHMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Siebria Health Services CurrentSince Aug 1, 2015 Accepting new patients

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.

Hospital & facility affiliations 4

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": "1359331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1255679171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4580 COMMONS PARK DR",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430548699",
            "telephone_number": "614-710-0727",
            "fax_number": "614-710-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4580 COMMONS PARK DR",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430548699",
            "telephone_number": "614-710-0077",
            "fax_number": "614-710-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "TIFFANI",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-28",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN267314",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "COA.17574-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0088547",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, OH

Sources for this page

Verify at the official NPI Registry.