Individual provider Active NPI

Tiffany Allen-Zunum, NP-C

  • Family Nurse Practitioner
  • New London, CT
National Provider Identifier
1922434489
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10185 Issued in CT
Practice address
255 Hempstead St
New London, CT 06320-6290
Phone
(860) 437-4550
NPI assigned
Sep 16, 2013
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NPP37788 RI
Family Nurse Practitioner 363LF0000X APRN00437 RI
Family Nurse Practitioner 363LF0000X 10185 CT Primary

Addresses

Primary practice location

255 Hempstead St
New London, CT 06320-6290

Mailing address

255 Hempstead St
New London, CT 06320-6290
Phone (860) 437-4550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140303001257 RI Practitioner - Nurse Practitioner 9931339462 Reassigns benefits to 1 organization
I20220815002026 CT Practitioner - Nurse Practitioner 9931339462 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10185CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Agency of Southeastern Connecticut, Inc. CurrentSince Aug 2, 2022 Accepting new patients
South County Primary Care, Inc. CurrentSince Nov 1, 2013 Accepting new patients

Locations

255 Hempstead St
New London, CT 06320

7 Vauxhall St
New London, CT 06320
Phone (860) 442-2797

360 Kingstown Rd
Narragansett, RI 02882
Phone (401) 783-6940

360 Kingstown Rd
Unit 104
Narragansett, RI 02882
Phone (401) 594-2200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1922434489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HEMPSTEAD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206290",
            "telephone_number": "860-437-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 HEMPSTEAD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206290",
            "telephone_number": "860-437-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN-ZUNUM",
        "first_name": "TIFFANY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2022-07-28",
        "certification_date": "2022-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "NPP37788",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN00437",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "10185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.