Individual provider Active NPI

Tiffany Danielle Felder, FNP

  • Family Nurse Practitioner
  • Papillion, NE
National Provider Identifier
1407381478
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
112477 Issued in NE
Practice address
611 Fenwick Dr
Papillion, NE 68046-5706
Phone
(402) 334-4773
Fax
(402) 445-8034
NPI assigned
Apr 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 112477 NE Primary

Addresses

Primary practice location

611 Fenwick Dr
Papillion, NE 68046-5706

Mailing address

611 Fenwick Dr
Papillion, NE 68046-5706
Phone (402) 334-4773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, NE2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180702002850 AL Practitioner - Nurse Practitioner 6305115841
I20180817001408 NE Practitioner - Nurse Practitioner 6305115841 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oncology Hematology West PCGroup PAC ID 8426030024, 56 clinicians

Practice addresses (Care Compare)

8303 Dodge St
Suite 250
Omaha, NE 68114-4108
Phone (402) 354-8124

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
112477NEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charles Drew Health Center, Inc. CurrentSince Jul 16, 2018 Accepting new patients
Charles Drew Health Center, Inc CurrentSince Jul 16, 2018 Accepting new patients
Health Services Inc CurrentSince Feb 1, 2018 Accepting new patients
Oncology Hematology West, PC CurrentSince Oct 12, 2020 Accepting new patients
Health Services, Inc. CurrentSince Feb 1, 2018 Accepting new patients
Oncology Hematology West, PC CurrentSince Oct 12, 2020 Accepting new patients
Charles Drew Health Center Inc PastSince May 25, 2021 Accepting new patients

Locations

511 E Tuskeena St
Hayneville, AL 36040
Phone (334) 548-2516

450 E 23rd St
Fremont, NE 68025
Phone (402) 721-1610

2915 Grant St
Omaha, NE 68111
Phone (402) 451-3553

8303 Dodge St
Ste 250
Omaha, NE 68114
Phone (402) 354-8124

7500 Mercy Rd
#1300
Omaha, NE 68124
Phone (402) 393-3110

611 Fenwick Dr
Papillion, NE 68046
Phone (402) 593-3141

Interoperability endpoints

  • Direct secure messaging: tiffany.felder.p1@direct.charlesdrew.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1407381478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 FENWICK DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680465706",
            "telephone_number": "402-334-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 FENWICK DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680465706",
            "telephone_number": "402-334-4773",
            "fax_number": "402-445-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDER",
        "first_name": "TIFFANY",
        "middle_name": "DANIELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-26",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "112477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

Verify at the official NPI Registry.