Individual provider Active NPI

Tiawana Deling Brown

  • Peer Specialist
  • Charlotte, NC
National Provider Identifier
1306610928
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
2022926601 Issued in NC
Practice address
2001 Catherine Simmons Ave
Charlotte, NC 28216-4677
Phone
(704) 792-1533
NPI assigned
Nov 14, 2023
Last updated
Nov 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 2022926601 NC Primary

Addresses

Primary practice location

2001 Catherine Simmons Ave
Charlotte, NC 28216-4677

Mailing address

5502 McChesney Dr
Charlotte, NC 28269-7188
Phone (704) 492-1533

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

LicenseStateTypeSpecialty
2022926601NCMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Cedric Dean Holdings Inc. Multi-Specialty CurrentSince Nov 19, 2023 Accepting new patients

Locations

2001 Catherine Simmons Ave
Charlotte, NC 28216
Phone (704) 492-1533

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1306610928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5502 MCCHESNEY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282697188",
            "telephone_number": "704-492-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 CATHERINE SIMMONS AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282164677",
            "telephone_number": "704-792-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TIAWANA",
        "middle_name": "DELING",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-14",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NC",
            "license": "2022926601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.