Tisa Allen, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN267228 Issued in PA

Practice address

2999 Philadelphia Pike
Claymont, DE 19703-2507

Phone

(302) 792-0700

Fax

(302) 792-0800

NPI assigned

Apr 28, 2022

Sex

Female

Sole proprietor

No

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 28, 2022.

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1821733593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2999 PHILADELPHIA PIKE",
            "city": "CLAYMONT",
            "state": "DE",
            "postal_code": "197032507",
            "telephone_number": "302-792-0700",
            "fax_number": "302-792-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2999 PHILADELPHIA PIKE",
            "city": "CLAYMONT",
            "state": "DE",
            "postal_code": "197032507",
            "telephone_number": "302-792-0700",
            "fax_number": "302-792-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "TISA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN267228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114079654",
            "state": "DE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.ctcprograms.claymont",
            "affiliation": "N",
            "endpointDescription": "Business location",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2999 Philadelphia Pike",
            "city": "Claymont",
            "state": "DE",
            "country_code": "US",
            "postal_code": "197032507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sunday Adekunle Adebayo
• Olubukola Adebote
• Affinity Health and Medical Systems
• Affinity Health Medical Systens
• Alight & Ascend Therapy LLC
• Ats of Delaware, LLC
• Takiyah Augustine
• Patricia Ayers, MSW, LCSW
• Back to Intelligent Design, LLC
• Erica Backenson

• All providers in Claymont, DE
• Licensed Practical Nurse in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.