Tiffany Lyn Harless, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

001332 Issued in WV

Practice address

4825 Maccorkle Ave SW
South Charleston, WV 25309-1365

Phone

(304) 346-9667

Fax

(304) 346-9717

NPI assigned

Jun 20, 2023

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

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1720763337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091365",
            "telephone_number": "304-346-9667",
            "fax_number": "304-346-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091365",
            "telephone_number": "304-346-9667",
            "fax_number": "304-346-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLESS",
        "first_name": "TIFFANY",
        "middle_name": "LYN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "001332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellie Anne Hansel, PA-C
• Tara Melgary Hansen, M.D.
• Whitney Brewer Hapney, RN, BSN
• Melissia Sue Hardin, M.A.
• Tanner Hardy
• Betty Harper
• Cathy Jo Harper
• Cheryl Harper
• Jennifer Harper
• Karla Harper

• Physical Therapy Assistant in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Physical Therapy Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.