Individual provider Active NPI

Tiffany Jane Wolfe, FNP-C

  • Family Nurse Practitioner
  • Waverly, OH
National Provider Identifier
1669735940
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.13366-NP Issued in OH
Practice address
12340 State Route 104
Waverly, OH 45690-8968
Phone
(740) 941-5180
NPI assigned
Jun 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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 COA.13366-NP OH Primary

Addresses

Primary practice location

12340 State Route 104
Waverly, OH 45690-8968

Mailing address

605 Washington St
Portsmouth, OH 45662-3919
Phone (740) 353-5153

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena.fam.med.waverly@adena.medicity.net

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
I20130104000105 OH Practitioner - Nurse Practitioner 0840443693 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adena Medical Group LLCGroup PAC ID 1153456579, 384 clinicians

Practice addresses (Care Compare)

12340 State Route 104
Waverly, OH 45690-8968
Phone (740) 941-5180

Hospital & facility affiliations

  • Adena Regional Medical Center Hospital, Chillicothe, OH, CCN 360159
  • Adena Pike Medical Center Hospital, Waverly, OH, CCN 361334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
COA.13366-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC CurrentSince Dec 11, 2023 Accepting new patients
City of Portsmouth CurrentSince Dec 30, 2014 Accepting new patients
City of Portsmouth CurrentSince Dec 30, 2014 Accepting new patients

Locations

272 Hospital Rd
Ste 6
Chillicothe, OH 45601

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

605 Washington St
Portsmouth, OH 45662
Phone (740) 353-0552

605 Washington St
Fl 2
Portsmouth, OH 45662

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Interoperability endpoints

  • Direct secure messaging: twolfe1166071@direct.osumc.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1669735940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 WASHINGTON ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623919",
            "telephone_number": "740-353-5153",
            "fax_number": "740-351-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12340 STATE ROUTE 104",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456908968",
            "telephone_number": "740-941-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "TIFFANY",
        "middle_name": "JANE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.13366-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.fam.med.waverly@adena.medicity.net",
            "affiliation": "N",
            "address_1": "12340 State Route 104",
            "city": "Waverly",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456908968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waverly, OH

Sources for this page

Verify at the official NPI Registry.