Individual provider Active NPI

Tiffany Martin-Thornton

  • Adult Health Nurse Practitioner
  • Garfield HTS, OH
National Provider Identifier
1902268691
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN.CNP.19217 Issued in OH
Practice address
12395 McCracken Rd
Garfield HTS, OH 44125-2967
Phone
(216) 587-6727
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN.CNP.19217 OH Primary
Gerontology Nurse Practitioner 363LG0600X APRN.CNP.19217 OH

Addresses

Primary practice location

12395 McCracken Rd
Garfield HTS, OH 44125-2967

Mailing address

12395 McCracken Rd
Garfield HTS, OH 44125-2967
Phone (216) 587-6727

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160810002606 OH Practitioner - Nurse Practitioner 2668766841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11811 Shaker Blvd
Suite 123
Cleveland, OH 44120-1927
Phone (216) 242-2990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.19217OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Proud to Be, Inc CurrentSince Jan 1, 2018 Accepting new patients
Proud to Be, Inc Past Accepting new patients
Kelli Anne Chamberlain Past Accepting new patients
Proud to Be, Inc Past Accepting new patients

Locations

11811 Shaker Blvd
Ste 123
Cleveland, OH 44120
Phone (216) 242-2990

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1902268691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12395 MCCRACKEN RD",
            "city": "GARFIELD HTS",
            "state": "OH",
            "postal_code": "441252967",
            "telephone_number": "216-587-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12395 MCCRACKEN RD",
            "city": "GARFIELD HTS",
            "state": "OH",
            "postal_code": "441252967",
            "telephone_number": "216-587-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN-THORNTON",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.19217",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.19217",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garfield HTS, OH

Sources for this page

Verify at the official NPI Registry.