Active NPI
Tyrranda Alliyah Phillips
- Home Health Aide
- Quincy, FL
National Provider Identifier
1962091876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 379861
- Practice address
- 241 Grove Rd
Quincy, FL 32351 - Phone
- (850) 491-9327
- NPI assigned
- Jan 14, 2021
- 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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 379861 | FL | Primary |
Addresses
Primary practice location
241 Grove Rd
Quincy, FL 32351
Mailing address
241 Grove Rd
Quincy, FL 32351
Phone (850) 491-9327
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 852232489 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 379861 | FL | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610582400000",
"number": "1962091876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "241 GROVE RD",
"city": "QUINCY",
"state": "FL",
"postal_code": "32351",
"telephone_number": "850-491-9327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "241 GROVE RD",
"city": "QUINCY",
"state": "FL",
"postal_code": "32351",
"telephone_number": "850-491-9327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "TYRRANDA",
"middle_name": "ALLIYAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-14",
"last_updated": "2021-01-14",
"certification_date": "2021-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "FL",
"license": "379861",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "852232489",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Quincy, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.