Tiffany Rochell Edmondson

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

825 E Main St
Blytheville, AR 72315-2521

Phone

(573) 391-0570

NPI assigned

Oct 4, 2020

Last updated

Oct 4, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Arkansas 1St Class Consumer Directed Services LLC

  • In Home Supportive Care Agency
  • Blytheville, AR
  • NPI 1134727613
  NPD Authorized official

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

{
    "created_epoch": "1601769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601769600000",
    "number": "1962009894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E MAIN ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152521",
            "telephone_number": "573-391-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E MAIN ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152521",
            "telephone_number": "573-391-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "TIFFANY",
        "middle_name": "ROCHELL",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-04",
        "last_updated": "2020-10-04",
        "certification_date": "2020-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "A1CDSTT@outlook.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "825 E Main St",
            "city": "Blytheville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "723152521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "A1CDSTT@outlook.com",
            "affiliation": "N",
            "address_1": "825 E Main St",
            "city": "Blytheville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "723152521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sylvia Dyer, MHPP
• Alexandria Lee Sides Easley
• East Arkansas Emergency Physicians, PLLC
• East Arkansas Family Health Center Inc (Healthy Partners)
• East Arkansas Family Health Center Inc. (Healthy Partners)
• Dana Edwards, RN
• Merideth Elder, MHPP
• Eldercare of Arkansas Inc. (Stonebridge of Blytheville)
• Susan Elkins, RN
• Kathleen Elliott, PD

• In Home Supportive Care Agency in Blytheville, AR
• Providers in Blytheville, AR by specialty
• In Home Supportive Care Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.