Individual provider Active NPI

Tiffany Leigh Rains

  • Social Worker
  • Fairfield, OH
National Provider Identifier
1912418351
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.1302968 Issued in OH
Practice address
6570 Sosna Dr
Fairfield, OH 45014-2222
Phone
(513) 942-4673
Fax
(513) 737-1107
NPI assigned
Oct 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1302968 OH Primary

Addresses

Primary practice location

6570 Sosna Dr
Fairfield, OH 45014-2222

Mailing address

6570 Sosna Dr
Fairfield, OH 45014-2222
Phone (513) 942-4673

Other identifiers 1

IdentifierTypeStateIssuer
S.1302968OtherOHLICENSURE BOARD

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
S.1302968OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Decoach Team LLC CurrentSince Dec 6, 2020 Accepting new patients
Decoach Team LLC PastSince Dec 6, 2020 Accepting new patients

Locations

6570 Sosna Dr
Fairfield, OH 45014
Phone (513) 942-4673

Organizations & group practices 2

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": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1912418351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6570 SOSNA DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142222",
            "telephone_number": "513-942-4673",
            "fax_number": "513-737-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6570 SOSNA DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142222",
            "telephone_number": "513-942-4673",
            "fax_number": "513-737-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINS",
        "first_name": "TIFFANY",
        "middle_name": "LEIGH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1302968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE BOARD",
            "identifier": "S.1302968",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.