Individual provider Active NPI

Tiffany Morgan St James, APN

  • Pediatric Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1457832263
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209016340 Issued in IL
Practice address
225 E Chicago Ave
Chicago, IL 60611-2991
Phone
(312) 227-4000
NPI assigned
Aug 29, 2018
Last updated
Aug 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209016340 IL Primary

Addresses

Primary practice location

225 E Chicago Ave
Chicago, IL 60611-2991

Mailing address

200 N Dearborn St Unit 3502
Chicago, IL 60601-1626
Phone (585) 354-2499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20181130001560 IL Practitioner - Nurse Practitioner 6608110754 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209016340ILMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lurie Childrens Pediatric Anesthesia Associates Current Accepting new patients
Lurie Childrens Surgical Foundation Inc CurrentSince Jul 22, 2021 Accepting new patients

Locations

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6415

225 E Chicago Ave
#118
Chicago, IL 60611

1121 Techny Rd
Northbrook, IL 60062
Phone (312) 227-2700

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/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": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1457832263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N DEARBORN ST UNIT 3502",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606011626",
            "telephone_number": "585-354-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST JAMES",
        "first_name": "TIFFANY",
        "middle_name": "MORGAN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209016340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.