Individual provider Active NPI

Tiffany Smith Roy, N.P.

  • Family Nurse Practitioner
  • Duson, LA
National Provider Identifier
1568645430
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP04568 Issued in LA
Practice address
110 W. First St
Suite a
Duson, LA 70529
Phone
(337) 873-8244
Fax
(337) 873-8274
NPI assigned
Dec 13, 2007
Last updated
Jul 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP04568 LA Primary

Addresses

Primary practice location

110 W. First St
Suite a
Duson, LA 70529

Mailing address

PO Box 370
Duson, LA 70529-0370
Phone (337) 873-8244

Other identifiers 2

IdentifierTypeStateIssuer
1592919MedicaidLA
3A809DF41OtherLAMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20080919000154 LA Practitioner - Nurse Practitioner 0648347401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tiffany Roy FNP LLCGroup PAC ID 9739256512, 9 clinicians

Practice addresses (Care Compare)

PO Box
Suite 370
Duson, LA 70529

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP04568LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tiffany Roy FNP LLC CurrentSince Sep 2, 2008 Accepting new patients
Tiffany Roy, FNP, L.L.C. CurrentSince Sep 2, 2008 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tiffany.roy.1@3274.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Duson Family HealthcareDuson, LA, CCN 193908 Rural health clinic 5% Or Greater Direct Ownership Interest
Corporate Officer (100%)
Sep 19, 2008
Apr 25, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1568645430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "DUSON",
            "state": "LA",
            "postal_code": "705290370",
            "telephone_number": "337-873-8244",
            "fax_number": "337-873-8274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W. FIRST ST",
            "address_2": "SUITE A",
            "city": "DUSON",
            "state": "LA",
            "postal_code": "70529",
            "telephone_number": "337-873-8244",
            "fax_number": "337-873-8274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "TIFFANY",
        "middle_name": "SMITH",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP04568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1592919",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "3A809DF41",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duson, LA

Sources for this page

Verify at the official NPI Registry.