Tiffani A Wilson

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

3234 Belair Rd
Baltimore, MD 21213-1228

Phone

(301) 979-7501

Fax

(301) 979-7638

NPI assigned

Jan 3, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1417618356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9411 HANNAHS MILL DR APT 304",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211176858",
            "telephone_number": "443-468-1816",
            "fax_number": "301-979-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3234 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212131228",
            "telephone_number": "301-979-7501",
            "fax_number": "301-979-7638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TIFFANI",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ringcentral.com",
            "affiliation": "N",
            "endpointDescription": "Telehealth and document sharing",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3234 Belair Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212131228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stanley Brewster Wilson III, CAC-AD
• Steve M Wilson, CRNP
• Tamara Wilson
• Tawana Wilson, LGPC
• Ted Lewis Wilson, PHYSICIANS ASSISTANT
• Tony F. Wilson II
• Tracey Wilson, CRNP
• Willie J Wilson Jr., CAC-AD
• Wilton L Wilson
• Zendy Wilson

• Community Health Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Community Health Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.