Tiffany M Gearhart, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

28248540A Issued in IN

Practice address

7613 W Jefferson Blvd
Fort Wayne, IN 46804-4181

Phone

(260) 469-7337

Fax

(260) 469-7340

NPI assigned

Mar 22, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tiffany M. Burke Former name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Great Lakes Pediatric Surgeons, Inc.

  • Pediatric Surgery Physician
  • Fort Wayne, IN
  • NPI 1669455267
  Medicare reassignment NPD

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1871242263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7613 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044181",
            "telephone_number": "260-469-7337",
            "fax_number": "260-469-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7613 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044181",
            "telephone_number": "260-469-7337",
            "fax_number": "260-469-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEARHART",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28248540A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "BURKE",
            "middle_name": "M.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cassidy Gavin, RBT
• Melodie A Gavin, RN
• Mark Steven Gawel
• Mina Gayed, DO
• Adam Gayer, LMHC
• Angela Robbins Gebert
• Gebfert-Park Family Dentistry
• Robert Gebfert, DDS
• Ryan P Gebfert, DMD
• Judith Geffen, RN

• Family Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.