Tiffany Deshelia Tyson, DNP, FNP-C, PMHNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5004707 Issued in NC

Practice address

2340 Spring Forest Rd
Raleigh, NC 27615-7528

Phone

(866) 389-2727

Fax

(401) 216-3854

NPI assigned

Apr 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Diagnostic of North Carolina PC 208 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles (7 of 11)

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: ttyson331393@direct.unc.nchie.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Minuteclinic Diagnostic of North Carolina PC

  • Family Nurse Practitioner
  • Raleigh, NC
  • NPI 1699748608

  Family, NC

  Medicare reassignment Care Compare group NPD
• Minuteclinic Primary Care North Carolina PLLC

  • Family Nurse Practitioner
  • Raleigh, NC
  • NPI 1356159818

  Family, NC

  Medicare reassignment NPD
• Opportunities Industrialization Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Rocky Mount, NC
  • NPI 1528478237

  NC

  Medicare reassignment NPD
• Opportunities Industrialization Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Rocky Mount, NC
  • NPI 1639661796

  NC

  Medicare reassignment NPD
• Opportunities Industrialization Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Rocky Mount, NC
  • NPI 1922020908

  NC

  Medicare reassignment NPD
• Opportunities Industrialization Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Rocky Mount, NC
  • NPI 1396103305

  NC

  Medicare reassignment NPD
• Opportunities Industrialization Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Rocky Mount, NC
  • NPI 1750734307

  NC

  Medicare reassignment NPD

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1497071153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2723",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278022723",
            "telephone_number": "252-210-9865",
            "fax_number": "252-822-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 SPRING FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276157528",
            "telephone_number": "866-389-2727",
            "fax_number": "401-216-3854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 N Grace St",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "278045345",
            "country_code": "US",
            "telephone_number": "252-210-9865",
            "fax_number": "252-822-5067",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "90 Guardian Ct",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "278043017",
            "country_code": "US",
            "telephone_number": "252-212-3350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYSON",
        "first_name": "TIFFANY",
        "middle_name": "DESHELIA",
        "credential": "DNP, FNP-C, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "179114",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5004707",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serena A Tyree
• Scott James Tyrey, MD
• Angela Fitzgerald Tyson, RN
• Chelsea Nicole Tyson, NP-C
• Jaclyn Tyson
• U.S Medical Supply
• U&N Medical Supplies Inc
• Maria Georgina Uberti, M.D
• Ucfa Physicians Network Group of North Carolina
• Valerie Uchegbu

• All providers in Raleigh, NC
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.