Tiffany McKennon

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

11039 Colonial Tavern LN
Jacksonville, FL 32221-2123

Phone

(904) 450-1430

NPI assigned

Jun 29, 2017

Last updated

Mar 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tiffany's Homemaker and Companion

  • In Home Supportive Care Agency
  • Jacksonville, FL
  • NPI 1205479342

  Home Health

  NPD Authorized official

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1720509755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11039 COLONIAL TAVERN LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322212123",
            "telephone_number": "904-450-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11039 COLONIAL TAVERN LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322212123",
            "telephone_number": "904-450-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNON",
        "first_name": "TIFFANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "10D2254281",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie McKee
• Jennifer McKeever, AP
• Gloria Susanne McKelvey, LMHC
• Colleen McKenna
• Ryan Timothy McKenna, D.O.
• Alexis McKenzie
• Amoyi McKenzie
• Ashama McKenzie, MSW
• Cherrie Burnett McKenzie, LCSW
• Felix Manuel McKenzie, MD

• Home Health Aide in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Home Health Aide in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.