Individual provider Active NPI

Tieuana Stanford

  • Registered Nurse
  • Columbus, OH
National Provider Identifier
1376027110
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.462546 Issued in OH
Practice address
1490 E Main St
Columbus, OH 43205-2140
Phone
(614) 252-0731
NPI assigned
Sep 18, 2018
Last updated
Jul 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X OH
Licensed Practical Nurse 164W00000X 160867 OH
Registered Nurse 163W00000X RN.462546 OH Primary

Addresses

Primary practice location

1490 E Main St
Columbus, OH 43205-2140

Mailing address

1490 E Main St
Columbus, OH 43205-2140
Phone (614) 252-0731

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
RN.462546OHMDRegistered Nurse
160867OHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeline Recovery LLC Past Accepting new patients

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": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1376027110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052140",
            "telephone_number": "614-252-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052140",
            "telephone_number": "614-252-0731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "TIEUANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "160867",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.462546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.