Tiffany Lachelle Avera

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

LD003667 Issued in GA

Practice address

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031

Phone

(404) 616-6172

NPI assigned

Mar 22, 2013

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 22, 2013.

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1447592985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 PANGBORN RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-616-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERA",
        "first_name": "TIFFANY",
        "middle_name": "LACHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-22",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "GA",
            "license": "LD003667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "949089",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Ave-Lallemant, LMFT
• Aveni Care of Ga LLC
• Aventine Injury Center
• Brittany Diane Avera, M.A., CCC-SLP
• Kristen Avera, RD, LD, CDCES
• Allen Madison Avery III, D.C.
• Arnita F Avery, DPM
• Jordan Avery
• Lenzie Avery
• Rashida Allen Avery, MD

• All providers in Atlanta, GA
• Pediatric Nutrition Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.