Ross E Tisron, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704162218 Issued in MI

Practice address

200 N Park St
West Michigan Cancer Center
Kalamazoo, MI 49007-3731

Phone

(269) 382-2500

Fax

(269) 373-7478

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1447204896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "BOX 42",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-7806",
            "fax_number": "269-341-8743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N PARK ST",
            "address_2": "WEST MICHIGAN CANCER CENTER",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073731",
            "telephone_number": "269-382-2500",
            "fax_number": "269-373-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISRON",
        "first_name": "ROSS",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704162218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4868770",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory P Tiongson, MD
• Nicole Tiongson
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• Justyce Tipton
• Alyssa Bethany Grace Tisdale, RD
• Ankita Tiwari
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• Heather Tobin
• Christopher S Todd, MD
• Bradley William Toepper, MS, AT, ATC

• Nurse Practitioner in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.