Individual provider Active NPI

Tiara Wright, PNP

  • Pediatric Nurse Practitioner
  • Fort Campbell, KY
National Provider Identifier
1578922811
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
20015 Issued in TN
Practice address
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone
(270) 798-8400
NPI assigned
Feb 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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 20015 TN Primary

Addresses

Primary practice location

650 Joel Dr
Fort Campbell, KY 42223-5318

Mailing address

1287 Bluffton Circle
Clarksville, TN 37043

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
20015TNMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1578922811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1287 BLUFFTON CIRCLE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "TIARA",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2024-10-01",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "20015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.