Individual provider Active NPI

Tiffany Moore Dewitt, CRNA

  • Certified Registered Nurse Anesthetist
  • Concord, NC
National Provider Identifier
1376849786
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
186952 Issued in NC
Practice address
920 Church St N
Concord, NC 28025-2927
Phone
(704) 403-3000
NPI assigned
Feb 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 186952 NC Primary

Addresses

Primary practice location

920 Church St N
Concord, NC 28025-2927

Mailing address

5025 Airport Center Pkwy BLDG L
Charlotte, NC 28208-5885
Phone (704) 512-7105

Other practice location 1

200 Hawthorne Ln
Charlotte, NC 28204-2515
Phone (704) 384-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121018000748 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325298870 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Anesthesia Services Group IncGroup PAC ID 5799007324, 742 clinicians

Practice addresses (Care Compare)

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 863-6000

Hospital & facility affiliations

  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2633NCMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Feb 13, 2018 Accepting new patients
CHS Anesthesia Services Group Inc CurrentSince Dec 13, 2017 Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Mar 1, 2017 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Nurse Anesthetist, Certified Registered CurrentSince Feb 13, 2018 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
The Presbyterian Hospital Nurse Anesthetist, Certified Registered CurrentSince Sep 5, 2012 Accepting new patients
Novant Health Rowan Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2017 Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376849786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5025 AIRPORT CENTER PKWY BLDG L",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282085885",
            "telephone_number": "704-512-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927",
            "telephone_number": "704-403-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawthorne Ln",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042515",
            "country_code": "US",
            "telephone_number": "704-384-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "TIFFANY",
        "middle_name": "MOORE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "186952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.