Individual provider Active NPI

Tiffany Christine Tary, OTR/L

  • Occupational Therapist
  • Lake Wales, FL
National Provider Identifier
1255801015
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT19172 Issued in FL
Practice address
512 S 11TH St
Lake Wales, FL 33853-4901
Phone
(713) 826-9788
NPI assigned
Dec 4, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT19172 FL Primary

Addresses

Primary practice location

512 S 11TH St
Lake Wales, FL 33853-4901

Mailing address

2537 N Orangewood St
Avon Park, FL 33825-7917
Phone (713) 826-9788

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1255801015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2537 N ORANGEWOOD ST",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338257917",
            "telephone_number": "713-826-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 S 11TH ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534901",
            "telephone_number": "713-826-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARY",
        "first_name": "TIFFANY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT19172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.