Active NPI
Tiffany Rachelle Manus, REGISTERED NURSE
- Registered Nurse
- London, OH
National Provider Identifier
1720685977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 421008
- Practice address
- 208 Lafayette St
London, OH 43140-9059 - Phone
- (740) 490-5675
- NPI assigned
- Oct 1, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 421008 | OH | Primary |
Addresses
Primary practice location
208 Lafayette St
London, OH 43140-9059
Mailing address
208 Lafayette St
London, OH 43140-9059
Phone (140) 490-5675
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0085173 | Medicaid | OH |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 421008 | OH | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601510400000",
"number": "1720685977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 LAFAYETTE ST",
"city": "LONDON",
"state": "OH",
"postal_code": "431409059",
"telephone_number": "140-490-5675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 LAFAYETTE ST",
"city": "LONDON",
"state": "OH",
"postal_code": "431409059",
"telephone_number": "740-490-5675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANUS",
"first_name": "TIFFANY",
"middle_name": "RACHELLE",
"credential": "REGISTERED NURSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-01",
"last_updated": "2020-10-01",
"certification_date": "2020-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "421008",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0085173",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in London, OH
- Madison Medical Center Urgent Care
- Madison Pediatrics, Inc.
- Madison-Plains Local School District
- Christopher K Madison Jr., MD
- Adam G. Manko, MD
- Mark a. Coate M.D. General Surgery Inc.
- Mark M. Lima, D.D.S. (London Dental Care)
- Ryan Anthony Martin
- Matco Industries (MATCO Services)
- Daniel C Maust, MED LPCC-S
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.