Active NPI
Tiffany Green
- Family Medicine Physician
- Sumter, SC
National Provider Identifier
1932903010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- LL95086
- Practice address
- 319 N Main St
Sumter, SC 29150-4258 - Phone
- (803) 434-6155
- NPI assigned
- Apr 1, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | LL95086 | SC | Primary |
Addresses
Primary practice location
319 N Main St
Sumter, SC 29150-4258
Mailing address
319 N Main St
Sumter, SC 29150-4258
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250807001153 | SC | Order and Referring Only - Family Practice | 1850899113 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- tiffany.green.1@13095.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752796800000",
"number": "1932903010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "319 N MAIN ST",
"city": "SUMTER",
"state": "SC",
"postal_code": "291504258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 N MAIN ST",
"city": "SUMTER",
"state": "SC",
"postal_code": "291504258",
"telephone_number": "803-434-6155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "TIFFANY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-04-01",
"last_updated": "2025-07-18",
"certification_date": "2025-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "LL95086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sumter, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.