Individual provider Active NPI

Tiara Chavis, LPN

  • Licensed Practical Nurse
  • Akron, OH
National Provider Identifier
1508104605
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
176285 Issued in OH
Practice address
202 Cascade CT
Akron, OH 44304-1253
Phone
(330) 808-9958
NPI assigned
Jan 24, 2013
Last updated
Jan 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 401316781111 OH
Licensed Practical Nurse 164W00000X 176285 OH Primary

Addresses

Primary practice location

202 Cascade CT
Akron, OH 44304-1253

Mailing address

202 Cascade CT
Akron, OH 44304-1253
Phone (330) 808-9958

Other identifiers 1

IdentifierTypeStateIssuer
0435538MedicaidOH

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
176285OHMDLicensed Practical Nurse
401316781111OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1508104605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 CASCADE CT",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041253",
            "telephone_number": "330-808-9958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CASCADE CT",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041253",
            "telephone_number": "330-808-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVIS",
        "first_name": "TIARA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "401316781111",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "176285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0435538",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.