Individual provider Active NPI

Tiffiny Ann Kluth

  • Social Worker
  • Fairmont, WV
National Provider Identifier
1740904465
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
AP00945385 Issued in WV
Practice address
909 Morgantown Ave
Fairmont, WV 26554-4335
Phone
(304) 366-5832
NPI assigned
Sep 27, 2022
Last updated
Sep 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X AP00945385 WV Primary

Addresses

Primary practice location

909 Morgantown Ave
Fairmont, WV 26554-4335

Mailing address

909 Morgantown Ave
Fairmont, WV 26554-4335
Phone (304) 366-5832

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

LicenseStateTypeSpecialty
AP00945385WVMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
National Youth Advocate Program PastSince Oct 2, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1740904465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 MORGANTOWN AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265544335",
            "telephone_number": "304-366-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 MORGANTOWN AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265544335",
            "telephone_number": "304-366-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUTH",
        "first_name": "TIFFINY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "AP00945385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.