Individual provider Active NPI

Tiffinea Michelle Reid-Johnson, LCSW

  • Clinical Social Worker
  • Murfreesboro, TN
National Provider Identifier
1386967925
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4537 Issued in TN
Practice address
2615 Medical Center Pkwy Ste 1560
Murfreesboro, TN 37129-3758
Phone
(931) 801-5020
NPI assigned
Mar 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4537 TN Primary

Addresses

Primary practice location

2615 Medical Center Pkwy Ste 1560
Murfreesboro, TN 37129-3758

Mailing address

2615 Medical Center Pkwy Ste 1560
Murfreesboro, TN 37129-3758
Phone (931) 801-5020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101209001145 TN Practitioner - Clinical Social Worker 8224225743 Practice locations: Murfreesboro, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2615 Medical Ctr Pkwy
Suite 1560
Murfreesboro, TN 37129-3758
Phone (615) 708-4539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4537TNMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1386967925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 MEDICAL CENTER PKWY STE 1560",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293758",
            "telephone_number": "931-801-5020",
            "fax_number": "931-553-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 MEDICAL CENTER PKWY STE 1560",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293758",
            "telephone_number": "931-801-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID-JOHNSON",
        "first_name": "TIFFINEA",
        "middle_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-10",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "4537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.