Tiffany Leigh Schultheis, RN

Primary specialty

Critical Care Medicine Registered NurseTaxonomy code 163WC0200X

License

2005008604 Issued in MO

Practice address

4507 Ashley LN
Fults, IL 62244-1529

Phone

(618) 458-7398

NPI assigned

Apr 23, 2010

Last updated

Apr 23, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Tiffany Leigh Metz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1497072912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4507 ASHLEY LN",
            "city": "FULTS",
            "state": "IL",
            "postal_code": "622441529",
            "telephone_number": "618-458-7398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4507 ASHLEY LN",
            "city": "FULTS",
            "state": "IL",
            "postal_code": "622441529",
            "telephone_number": "618-458-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTHEIS",
        "first_name": "TIFFANY",
        "middle_name": "LEIGH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041356623",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MO",
            "license": "2005008604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "METZ",
            "middle_name": "LEIGH",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Leigh Knobloch, NP-C

• Critical Care Medicine Registered Nurse in Fults, IL
• Providers in Fults, IL by specialty
• Critical Care Medicine Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.