Active NPI
Tiesha Davis
- Home Health Agency
- Kissimmee, FL
National Provider Identifier
1326712407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 382679
- Practice address
- 3817 Carrick Bend Dr
Kissimmee, FL 34746-2975 - Phone
- (689) 224-5766
- NPI assigned
- Aug 3, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 382679 | FL | Primary |
Addresses
Primary practice location
3817 Carrick Bend Dr
Kissimmee, FL 34746-2975
Mailing address
3817 Carrick Bend Dr
Kissimmee, FL 34746-2975
Phone (689) 224-5766
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tyetaylor1992@icloud.com | Direct |
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 |
|---|---|---|---|
| 382679 | FL | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627948800000",
"number": "1326712407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3817 CARRICK BEND DR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347462975",
"telephone_number": "689-224-5766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3817 CARRICK BEND DR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347462975",
"telephone_number": "689-224-5766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "TIESHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-03",
"last_updated": "2021-08-03",
"certification_date": "2021-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "FL",
"license": "382679",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tyetaylor1992@icloud.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "3817 Carrick Bend Dr",
"city": "Kissimmee",
"state": "FL",
"country_code": "US",
"postal_code": "347462975",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.