Individual provider Active NPI

Tyffany Nyland

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1639588189
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5007049 Issued in NC
Practice address
2709 Water Ridge Pkwy Ste 500
Charlotte, NC 28217
Phone
(855) 438-0010
NPI assigned
Aug 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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 5007049 NC Primary

Addresses

Primary practice location

2709 Water Ridge Pkwy Ste 500
Charlotte, NC 28217

Mailing address

2709 Water Ridge Pkwy Ste 500
Charlotte, NC 28217-4592
Phone (855) 438-0010

Other practice location 1

6030 W Highway 74
Suite A
Indian Trail, NC 28079-3468
Phone (704) 246-2777

Other practice location 2

2709 Water Ridge Pkwy Ste 500
Charlotte, NC 28217
Phone (855) 438-0010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20141210002507 NC Practitioner - Nurse Practitioner 9931421443 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

14214 Ballantyne Lake Rd
Suite 100
Charlotte, NC 28277-3373
Phone (704) 667-2650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Jul 21, 2019 Accepting new patients
Indycare Medical North Carolina CurrentSince Dec 31, 2018 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

110 Boone Square St
Ste 29A
Hillsborough, NC 27278
Phone (919) 245-1213

110 Boone Square St
Hillsborough, NC 27278

6030 W Highway 74
Ste A
Indian Trail, NC 28079
Phone (704) 246-2777

Interoperability endpoints

  • Direct secure messaging: tnyland342145@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1639588189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 WATER RIDGE PKWY STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282174592",
            "telephone_number": "855-438-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 WATER RIDGE PKWY STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28217",
            "telephone_number": "855-438-0010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6030 W Highway 74",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Indian Trail",
            "state": "NC",
            "postal_code": "280793468",
            "country_code": "US",
            "telephone_number": "704-246-2777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2709 Water Ridge Pkwy Ste 500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28217",
            "country_code": "US",
            "telephone_number": "855-438-0010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYLAND",
        "first_name": "TYFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-08",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5007049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.