Tiffany Therese Richards, APRN FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71003700A Issued in IN

Practice address

100 South Main Street
Suite 2
North Liberty, IN 46554

Phone

(574) 656-3919

Fax

(574) 656-3107

NPI assigned

Nov 2, 2011

Last updated

Feb 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2023 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: trichards1147702@direct.trinity-health.org

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.

• Liberty Center Family Medicine

  • Primary Care Clinic/Center
  • North Liberty, IN
  • NPI 1578293684
  NPD
• Saint Joseph Regional Medical Center- Plymouth Campus Inc

  dba Saint Joseph Foot and Ankle Sports Medicine Institute Plymouth

  • Family Medicine Physician
  • Plymouth, IN
  • NPI 1538585187
  NPD (past)
• Saint Joseph Regional Medical Center, Inc.

  dba Saint Joseph Medical Group

  • Pulmonary Disease Physician
  • Plymouth, IN
  • NPI 1225082878

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1740566827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SOUTH MAIN STREET P.O. BOX 315",
            "address_2": "SUITE 2",
            "city": "NORTH LIBERTY",
            "state": "IN",
            "postal_code": "46554",
            "telephone_number": "574-656-3919",
            "fax_number": "574-656-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SOUTH MAIN STREET",
            "address_2": "SUITE 2",
            "city": "NORTH LIBERTY",
            "state": "IN",
            "postal_code": "46554",
            "telephone_number": "574-656-3919",
            "fax_number": "574-656-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "TIFFANY",
        "middle_name": "THERESE",
        "name_prefix": "Mrs.",
        "credential": "APRN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-02",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71003700A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28147328A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201077780",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000816222",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Kosinski, OTR
• Liberty Center Family Medicine
• Liberty Township Trustee
• James Mitchell, OTR
• Justine Marie Prikosovich, PTA, CNS
• Shamrock Health and Wellness Clinic, LLC
• Anita Ellen Shipley
• Sara Marie Singleton, FNP

• Nurse Practitioner in North Liberty, IN
• Providers in North Liberty, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.