Active NPI
Tiffany O'Connell, LPN
- Licensed Practical Nurse
- Martinez, CA
National Provider Identifier
1265803860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- P011922
- Practice address
- 150 Muir Rd
Martinez, CA 94553 - Phone
- (925) 372-2000
- NPI assigned
- Oct 8, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | P011922 | SD | Primary |
Addresses
Primary practice location
150 Muir Rd
Martinez, CA 94553
Mailing address
1713 Herman St
Rapid City, SD 57701
Phone (770) 238-2102
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P011922 | SD | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444262400000",
"number": "1265803860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1713 HERMAN ST",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "57701",
"telephone_number": "770-238-2102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 MUIR RD",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "94553",
"telephone_number": "925-372-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNELL",
"first_name": "TIFFANY",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-08",
"last_updated": "2015-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "SD",
"license": "P011922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.