Tyrahna Jefferson, CRANIAL PROSTHESIS

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

Practice address

6340 Security Blvd Ste 100
Baltimore, MD 21207-5284

Phone

(410) 304-3127

NPI assigned

Jun 7, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Divine Beauty & Wellness LLC

  • Prosthetics Case Management
  • Baltimore, MD
  • NPI 1578062055

  Reflexologist

  NPD (past) Authorized official

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1649629064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6340 SECURITY BLVD STE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212075284",
            "telephone_number": "410-304-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6340 SECURITY BLVD STE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212075284",
            "telephone_number": "410-304-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "TYRAHNA",
        "credential": "CRANIAL PROSTHESIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Artrish Jefferson, MD
• Jaimon Jefferson
• Lamont Jefferson
• Patricia Moody Jefferson, MSW, LCSW-C, LCSW
• Samantha Brooke Jefferson, LCSW-C
• Dean Thomas Jeffery, M.D., FRCPC
• Monifa S Jeffrey-Riggins, MSW, LCSWC
• Ronald D. Jeffreys, D.O.
• Ashley Marie Jeffries, LCSW-C
• Brianna Jeffries

• Prosthetics Case Management in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Prosthetics Case Management in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.