Tammy Lynn Micco, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP16567 Issued in OH

Practice address

4650 Hills and Dales Rd NW
Canton, OH 44708

Phone

(330) 649-9400

Fax

(330) 649-8059

NPI assigned

Oct 7, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cnpmicco@kandh.medentdirect.com

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.

• Kidney & Hypertension Consultants, Inc.

  • Nephrology Physician
  • Canton, OH
  • NPI 1770524696
  Medicare reassignment NPD

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1265835102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 HILLS AND DALES RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44708",
            "telephone_number": "330-649-9400",
            "fax_number": "330-649-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 HILLS AND DALES RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44708",
            "telephone_number": "330-649-9400",
            "fax_number": "330-649-8059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICCO",
        "first_name": "TAMMY",
        "middle_name": "LYNN",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "16567",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP16567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "16567",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maggie L Metzger, LSW
• Grace Meuleman, QMHS, CDCA
• Denise Meyer, SWT
• Todd A Meyerhoefer, MD
• Emma Lee Micco
• Kristin Miceli
• Michael a. Rich, M.D. and Associates, Inc.
• Michael and Brittany Thomas DDS LLC
• Michael Tirmonia, DO, Inc
• Micaela Marie Michalk

• Nurse Practitioner in Canton, OH
• Providers in Canton, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.