Individual provider Active NPI

Tiffany D Addy

  • Registered Nurse
  • Cambridge, OH
National Provider Identifier
1790388692
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.512056 Issued in OH
Practice address
841 Steubenville Ave
Cambridge, OH 43725-2301
Phone
(855) 692-7247
NPI assigned
Nov 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN.173673.MEDS-IV OH
Registered Nurse 163W00000X RN.512056 OH Primary

Addresses

Primary practice location

841 Steubenville Ave
Cambridge, OH 43725-2301

Mailing address

841 Steubenville Ave
Cambridge, OH 43725-2301
Phone (855) 692-7247

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
RN.512056OHMDRegistered Nurse
LPN.173673.MEDS-IVOHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Ridge Behavioral Health Solutions LLC CurrentSince Nov 29, 2020 Accepting new patients
Cedar Ridge Behavioral Health Solutions PastSince Nov 29, 2020 Accepting new patients

Locations

841 Steubenville Ave
Cambridge, OH 43725
Phone (855) 962-7247

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1790388692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 STEUBENVILLE AVE",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437252301",
            "telephone_number": "855-692-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 STEUBENVILLE AVE",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437252301",
            "telephone_number": "855-692-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDY",
        "first_name": "TIFFANY",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-21",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.173673.MEDS-IV",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.512056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.