Active NPI
Tiffany Maxwell Ebert
- Rehabilitation Psychologist
- Haworth, OK
National Provider Identifier
1922243724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Psychologist
- Practice address
- HC 60 Box 2470
Haworth, OK 74740-9675 - Phone
- (580) 212-9925
- NPI assigned
- Dec 8, 2008
- Last updated
- Apr 10, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Psychologist | 103TR0400X | NU | Primary |
Addresses
Primary practice location
HC 60 Box 2470
Haworth, OK 74740-9675
Mailing address
HC 60 Box 2470
Haworth, OK 74740-9675
Phone (580) 212-9925
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239321600000",
"number": "1922243724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 60 BOX 2470",
"city": "HAWORTH",
"state": "OK",
"postal_code": "747409675",
"telephone_number": "580-212-9925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HC 60 BOX 2470",
"city": "HAWORTH",
"state": "OK",
"postal_code": "747409675",
"telephone_number": "580-212-9925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXWELL EBERT",
"first_name": "TIFFANY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-08",
"last_updated": "2009-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haworth, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.