Tiffany Nicole Eller

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P013856 Issued in NC

Practice address

3325 Durham Chapel Hill Blvd Ste 210
Durham, NC 27707-2646

Phone

(919) 338-0939

Fax

(984) 888-0913

NPI assigned

Sep 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Carolina Outreach, LLC

  • Community/Behavioral Health Agency
  • Durham, NC
  • NPI 1679956601
  NPD (past)

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1700437613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 DURHAM CHAPEL HILL BLVD STE 210",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072646",
            "telephone_number": "919-338-0939",
            "fax_number": "984-888-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 DURHAM CHAPEL HILL BLVD STE 210",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072646",
            "telephone_number": "919-338-0939",
            "fax_number": "984-888-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLER",
        "first_name": "TIFFANY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Wellness & Healthcare
• Denise Elizondo, MD
• Jon M Elkin, FNP-C
• Mary Kathryn Elledge
• Rachael Davis Elledge, MS, RD, LDN
• Sarah Ellestad, M.D.
• Ellie Bash, DDS, Ms, PA
• Ellingson Family Chiropractic, PA
• Eric Ellingson, D.C.
• Heather Renee Ellington, FNP

• Clinical Social Worker in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.