Tiffany Maddox, SPECIALIST

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Practice address

14497 Potomac Mills Rd # 1013
Woodbridge, VA 22192-6807

Phone

(571) 570-6361

Fax

(276) 530-4153

NPI assigned

May 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Tiffany Williams Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1265016141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9914 HAGEL CIR",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220794306",
            "telephone_number": "832-537-4426",
            "fax_number": "276-530-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14497 POTOMAC MILLS RD # 1013",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221926807",
            "telephone_number": "571-570-6361",
            "fax_number": "276-530-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "TIFFANY",
        "credential": "SPECIALIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Woodbridge",
            "affiliation": "N",
            "endpointDescription": "server Simple Practice",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14497 Potomac Mills Rd # 1013",
            "city": "Woodbridge",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221926807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "WILLIAMS",
            "prefix": "MRS.",
            "credential": "SPECIALIST",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Prosthetic/Orthotic Supplier in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.