Individual provider Active NPI

Tiffani Nicole Welzin, PHLEBOTOMIST/MA

  • Phlebotomy Technician
  • Dearborn, MI
National Provider Identifier
1679178123
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
Practice address
22976 Outer Dr
Dearborn, MI 48124-4279
Phone
(313) 953-8768
NPI assigned
Dec 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X
Phlebotomy Technician 246RP1900X MI Primary

Addresses

Primary practice location

22976 Outer Dr
Dearborn, MI 48124-4279

Mailing address

22976 Outer Dr
Dearborn, MI 48124-4279
Phone (313) 953-8768

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.dynamichando.com Direct

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)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Health and Occupational Services CurrentSince Jul 24, 2022 Accepting new patients
Shelton Professional Phlebotomy Services LLC PastSince Dec 13, 2020 Accepting new patients

Locations

22976 Outer Dr
Dearborn, MI 48124
Phone (313) 359-1000

Organizations & group practices 2

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": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679178123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22976 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244279",
            "telephone_number": "313-953-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22976 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244279",
            "telephone_number": "313-953-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELZIN",
        "first_name": "TIFFANI",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PHLEBOTOMIST/MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-02",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.dynamichando.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "22976 Outer Dr",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481244279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.