Tiffany Bowen, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71006816A Issued in IN

Practice address

508 Legacy PLZ W
La Porte, IN 46350-5254

Phone

(219) 575-6244

Fax

(219) 380-0757

NPI assigned

Nov 8, 2016

Last updated

Jul 21, 2022By 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 names 1

• Tiffany Efantis Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tiffany.bowen@laportehosp.cernerdirect.com

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.

• Chestnut Health of Indiana PC

  • Internal Medicine Physician
  • Kokomo, IN
  • NPI 1730884131
  Medicare reassignment NPD
• Porter Physician Services LLC

  • Family Medicine Physician
  • Valparaiso, IN
  • NPI 1508075680
  Medicare reassignment NPD
• Porter Physician Services LLC

  • Internal Medicine Physician
  • Portage, IN
  • NPI 1457566309
  NPD (past)

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750823795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172808",
            "telephone_number": "574-239-1433",
            "fax_number": "574-239-1438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 LEGACY PLZ W",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463505254",
            "telephone_number": "219-575-6244",
            "fax_number": "219-380-0757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 N Eddy St",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466172808",
            "country_code": "US",
            "telephone_number": "574-239-1433",
            "fax_number": "574-239-1438",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "809 LaPorte Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463835801",
            "country_code": "US",
            "telephone_number": "219-263-4977",
            "fax_number": "219-263-4979",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 Dickinson Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterton",
            "state": "IN",
            "postal_code": "463043387",
            "country_code": "US",
            "telephone_number": "219-926-7755",
            "fax_number": "219-929-1885",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3630 Willowcreek Rd",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "IN",
            "postal_code": "463685075",
            "country_code": "US",
            "telephone_number": "219-364-3900",
            "fax_number": "219-364-3959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "TIFFANY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-08",
        "last_updated": "2022-07-21",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28199198A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006816A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Tiffany.Bowen@laportehosp.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "508 Legacy Plz W",
            "city": "LA Porte",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463505254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "EFANTIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pamela Ann Boardman, P.T.
• Janice Marie Bohlim, NP
• Dawn L. Bohnert, O.D.
• Michelle Boren, LMHC, LCAC
• Marissa Bottos, FNP, APRN
• Stacy Lynn Brand-Lesley, LCSW
• Carley Joy Brewster, DNP
• Brittany Brice, FNP-C
• Sarah Georgetta Jean Brinckman
• Barney Lee Brooks

• Family Nurse Practitioner in La Porte, IN
• Providers in La Porte, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.