Active NPI
Tiffany McComb
- Registered Nurse
- Kendallville, IN
National Provider Identifier
1306333851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 28196832A
- Practice address
- 1844 Ida Red Rd
Kendallville, IN 46755-2873 - Phone
- (260) 347-8810
- NPI assigned
- Apr 20, 2018
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28196832A | IN | Primary |
Addresses
Primary practice location
1844 Ida Red Rd
Kendallville, IN 46755-2873
Mailing address
3702 New Vision Dr BLDG B
Fort Wayne, IN 46845-1703
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 |
|---|---|---|---|
| 28196832A | IN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524182400000",
"number": "1306333851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3702 NEW VISION DR BLDG B",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1844 IDA RED RD",
"city": "KENDALLVILLE",
"state": "IN",
"postal_code": "467552873",
"telephone_number": "260-347-8810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOMB",
"first_name": "TIFFANY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-20",
"last_updated": "2018-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IN",
"license": "28196832A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kendallville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.