Individual provider Active NPI

Tiffany McClain, RN

  • Home Health Registered Nurse
  • Augusta, GA
National Provider Identifier
1861053779
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
RN227072 Issued in GA
Practice address
2402 Bowdoin Dr
Augusta, GA 30909-4521
Phone
(706) 664-9708
NPI assigned
Jun 23, 2019
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X RN227072 GA Primary
Clinical Medical Laboratory 291U00000X 11D2238251 GA

Addresses

Primary practice location

2402 Bowdoin Dr
Augusta, GA 30909-4521

Mailing address

2402 Bowdoin Dr
Augusta, GA 30909-4521
Phone (706) 664-9708

Other practice location 1

3123 Scenic Dr # Na
Augusta, GA 30909-4263
Phone (706) 664-9708

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN227072GAMDHome Health Registered Nurse
11D2238251GAMDClinical Medical Laboratory

NPI Registry JSON

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

{
    "created_epoch": "1561248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1861053779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 BOWDOIN DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309094521",
            "telephone_number": "706-664-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 BOWDOIN DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309094521",
            "telephone_number": "706-664-9708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3123 Scenic Dr # Na",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309094263",
            "country_code": "US",
            "telephone_number": "706-664-9708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLAIN",
        "first_name": "TIFFANY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-23",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "GA",
            "license": "RN227072",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "11D2238251",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.