Individual provider Active NPI

Tifany Jamison, APN, FNP-BC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1285184150
Registry record updated Feb 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209014920 Issued in IL
Practice address
230 W Monroe St
Suite 2540
Chicago, IL 60606-4703
Phone
(708) 979-9788
NPI assigned
Oct 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209014920 IL Primary

Addresses

Primary practice location

230 W Monroe St
Suite 2540
Chicago, IL 60606-4703

Mailing address

PO Box 2591
Orland Park, IL 60462-1092
Phone (708) 979-9788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20170125002616 IL Practitioner - Nurse Practitioner 8426330523

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209014920ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hansa Medical Groupe PLLC CurrentSince Oct 27, 2019 Accepting new patients
Community Care Health Network LLC CurrentSince May 1, 2021 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

100 Illinois St
Ste 200
St Charles, IL 60174
Phone (630) 513-5576

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486166400000",
    "number": "1285184150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2591",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621092",
            "telephone_number": "708-979-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W MONROE ST",
            "address_2": "SUITE 2540",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606064703",
            "telephone_number": "708-979-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMISON",
        "first_name": "TIFANY",
        "credential": "APN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2017-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.