Individual provider Active NPI

Tiffany Speck

  • Women's Health Nurse Practitioner
  • Merriam, KS
National Provider Identifier
1447649629
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
53-76414-111 Issued in KS
Practice address
7440 Frontage Rd
Merriam, KS 66203-4670
Phone
(913) 236-6455
NPI assigned
Jan 12, 2015
Last updated
Jan 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 53-76414-111 KS Primary

Addresses

Primary practice location

7440 Frontage Rd
Merriam, KS 66203-4670

Mailing address

7440 Frontage Rd
Merriam, KS 66203-4670
Phone (913) 236-6455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-76414-111KSMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson County OB-GYN Chartered PastSince Jun 1, 2016 Accepting new patients
Womens Care Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1447649629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7440 FRONTAGE RD",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662034670",
            "telephone_number": "913-236-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7440 FRONTAGE RD",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662034670",
            "telephone_number": "913-236-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECK",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KS",
            "license": "53-76414-111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merriam, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.