Tiffany Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

TIFFANY HEALTHCARE LLC

Doing business as

Tiffany Heights

Practice address

1531 Nebraska St
Mound City, MO 64470-1610

Phone

(660) 442-3146

NPI assigned

Feb 20, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Renee Zucca

Title

Dosp

Phone

(816) 564-6978

Specialties & licenses 2

Addresses

Other names 1

• Tiffany Heights Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dustin Charles Carpenter, M.D.

  • Family Medicine Physician
  • Mound City, MO
  • NPI 1396033072
  NPD (past)
• John T Symonds, DO

  • Family Medicine Physician
  • Maryville, MO
  • NPI 1922035070
  NPD (past)

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1790483642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12401 E 43RD ST S STE 201",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555911",
            "telephone_number": "816-564-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 NEBRASKA ST",
            "city": "MOUND CITY",
            "state": "MO",
            "postal_code": "644701610",
            "telephone_number": "660-442-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFFANY HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "ZUCCA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "DOSP",
        "authorized_official_telephone_number": "816-564-6978",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tiffany Heights",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tiffany Heights",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul Thomas
• Tiffany Care Centers, Inc (Tiffany In Home Services)
• Tiffany Care Centers, Inc (Tiffany In Home Services)
• Tiffany Care Centers, Inc (Tiffany In Home Services)
• Tiffany Care Centers, Inc. (Tiffany Heights)
• Megan Wallace

• Skilled Nursing Facility in Mound City, MO
• Providers in Mound City, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.