Individual provider Active NPI

Tiffany Renee Caldwell, LPN

  • Licensed Practical Nurse
  • Athens, OH
National Provider Identifier
1881041796
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.127157-M-IV Issued in OH
Practice address
8978 United LN Ste 102
Athens, OH 45701-3668
Phone
(740) 274-4246
NPI assigned
May 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN.127157.MEDS-IV OH
Licensed Practical Nurse 164W00000X PN.127157-M-IV OH Primary

Addresses

Primary practice location

8978 United LN Ste 102
Athens, OH 45701-3668

Mailing address

8978 United LN Ste 102
Athens, OH 45701-3668
Phone (740) 274-4246

Other names 1

  • Tiffany Renee Predragovich Former name

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

State licenses

LicenseStateTypeSpecialty
LPN.127157.MEDS-IVOHMDLicensed Practical Nurse
PN.127157-M-IVOHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Treatment Centers Oh-Xvi, LLC CurrentSince Nov 12, 2023 Accepting new patients

Locations

8978 United Ln
#102
Athens, OH 45701
Phone (740) 274-4246

Organizations & group practices 1

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": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1881041796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8978 UNITED LN STE 102",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457013668",
            "telephone_number": "740-274-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8978 UNITED LN STE 102",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457013668",
            "telephone_number": "740-274-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "TIFFANY",
        "middle_name": "RENEE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.127157.MEDS-IV",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.127157-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "PREDRAGOVICH",
            "middle_name": "RENEE",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Athens, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.