Individual provider Active NPI

Tiffany Rae Morales, CPNP

  • Nurse Practitioner
  • Boardman, OH
National Provider Identifier
1629419718
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
COA.14856-NP Issued in OH
Practice address
8423 Market St Ste 300
Boardman, OH 44512-6778
Phone
(330) 543-8885
Fax
(330) 543-8890
NPI assigned
Jul 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA.14856-NP OH Primary

Addresses

Primary practice location

8423 Market St Ste 300
Boardman, OH 44512-6778

Mailing address

1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 543-8885

Other names 1

  • Tiffany Rae Robenolt Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tmorales10284@direct.chmca.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20131007001615 OH Practitioner - Nurse Practitioner 9739313776 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.14856-NPOHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Akron Children'S Hospital Current Accepting new patients
Children'S Hospital Medical Center of Akron Current Accepting new patients
Children'S Hospital Medical Center of Akron CurrentSince Aug 24, 2013 Accepting new patients
Children'S Hospital Medical Center of Akron Current Accepting new patients

Locations

1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050

8423 Market St
Ste 300
Youngstown, OH 44512
Phone (330) 543-8885

6505 Market St
Bldg A
Youngstown, OH 44512
Phone (330) 651-1789

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1629419718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-8885",
            "fax_number": "330-543-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8423 MARKET ST STE 300",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126778",
            "telephone_number": "330-543-8885",
            "fax_number": "330-543-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "TIFFANY",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.14856-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmorales10284@direct.chmca.org",
            "affiliation": "N",
            "address_1": "8423 Market St Ste 300",
            "city": "Boardman",
            "state": "OH",
            "country_code": "US",
            "postal_code": "445126778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "ROBENOLT",
            "middle_name": "RAE",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.