Individual provider Active NPI

Tiffany Lynn Wissman, MD

  • Pediatrics Physician
  • Huber Heights, OH
National Provider Identifier
1811208259
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35120987 Issued in OH
Practice address
8501 Old Troy Pike Ste 120
Huber Heights, OH 45424-1061
Phone
(937) 237-4945
Fax
(937) 237-4925
NPI assigned
Jun 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35120987 OH Primary

Addresses

Primary practice location

8501 Old Troy Pike Ste 120
Huber Heights, OH 45424-1061

Mailing address

PO Box 933432
Cleveland, OH 44193-0039
Phone (937) 641-5072

Other practice location 1

1152 W 3rd St Ste 102
Dayton, OH 45402-6848
Phone (937) 268-3483

Other practice location 2

3333 W Tech Rd
Miamisburg, OH 45342-0955
Phone (937) 748-6116

Other practice location 3

200 Rockridge Rd Ste 110
Englewood, OH 45322-2751
Phone (937) 836-9921

Other practice location 4

1425 N Fairfield Rd
Beavercreek, OH 45432-2673
Phone (937) 641-3888

Other practice location 5

6551 Centerville Business Pkwy
Centerville, OH 45459-2695
Phone (937) 291-6850

Other identifiers 1

IdentifierTypeStateIssuer
0082872MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016002446 OH Practitioner - Pediatric Medicine 4486009149 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35120987OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Children'S Specialty Physicians, Inc. Pediatrics CurrentSince Oct 2, 2023 Accepting new patients
Dayton Children'S Specialty Physicians, Inc. Pediatrics CurrentSince Jan 14, 2024 Accepting new patients
Premier Integrated Medical Assoc LTD Pediatrics Past Accepting new patients
Premier Integrated Medical Assoc Pediatrics Past Accepting new patients

Locations

1425 N Fairfield Rd
Ste 120
Beavercreek, OH 45432
Phone (937) 320-3888

1152 W 3rd St
Ste 102
Dayton, OH 45402
Phone (937) 268-3483

6551 Centerville Business Pkwy
Dayton, OH 45459
Phone (937) 291-6850

6551 Centerville Business Pkwy
Ste 110
Dayton, OH 45459
Phone (937) 291-6850

200 Rockridge Rd
Ste 110
Englewood, OH 45322
Phone (937) 836-9921

8501 Old Troy Pike
Ste 120
Huber Heights, OH 45424
Phone (937) 237-4945

967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330

3333 W Tech Rd
Miamisburg, OH 45342
Phone (937) 641-3400

3333 W Tech Rd
Ste 120
Miamisburg, OH 45342
Phone (937) 748-6116

Organizations & group practices 4

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1811208259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933432",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-5072",
            "fax_number": "937-641-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 OLD TROY PIKE STE 120",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454241061",
            "telephone_number": "937-237-4945",
            "fax_number": "937-237-4925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1152 W 3rd St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454026848",
            "country_code": "US",
            "telephone_number": "937-268-3483",
            "fax_number": "937-268-1884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 W Tech Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420955",
            "country_code": "US",
            "telephone_number": "937-748-6116",
            "fax_number": "937-291-6956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Rockridge Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "453222751",
            "country_code": "US",
            "telephone_number": "937-836-9921",
            "fax_number": "937-836-1298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1425 N Fairfield Rd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454322673",
            "country_code": "US",
            "telephone_number": "937-641-3888",
            "fax_number": "937-320-3848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6551 Centerville Business Pkwy",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454592695",
            "country_code": "US",
            "telephone_number": "937-291-6850",
            "fax_number": "937-291-6896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISSMAN",
        "first_name": "TIFFANY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35120987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082872",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huber Heights, OH

Sources for this page

Verify at the official NPI Registry.