Tiffany Dianne Dineen, AGNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

25803 Issued in SC

Practice address

251 University Blvd
Ste B
Conway, SC 29526-8834

Phone

(843) 347-1012

Fax

(843) 347-1218

NPI assigned

Apr 8, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tiffany Dianne Fogle Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Conway Hospital IncGroup PAC ID 7113839606, 127 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Conway Hospital, Inc.

  • General Acute Care Hospital
  • Conway, SC
  • NPI 1134172000
  Medicare reassignment Care Compare group NPD
• Conway Hospital, Inc.

  • Vascular Surgery Physician
  • Conway, SC
  • NPI 1134910763
  NPD
• Conway Hospital, Inc.

  • Internal Medicine Physician
  • Little River, SC
  • NPI 1558025783

  Adult Health

  NPD (past)

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1972245256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTN PNS CREDENTIALING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 UNIVERSITY BLVD",
            "address_2": "STE B",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268834",
            "telephone_number": "843-347-1012",
            "fax_number": "843-347-1218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 University Blvd",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295268834",
            "country_code": "US",
            "telephone_number": "843-347-0524",
            "fax_number": "843-347-0655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DINEEN",
        "first_name": "TIFFANY",
        "middle_name": "DIANNE",
        "name_prefix": "Ms.",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-08",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "25803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "FOGLE",
            "middle_name": "DIANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephen Dew, PHARMD
• Mayme Dewey
• Derrica Dewitt
• Jonathan L Dieter Jr., MD
• Wyatt H Dimmick, DPT, PT
• Terry Carlyle Dixon, M.D., PH.D.
• Doctors Care SC, PA
• Doctors Care SC, PA
• Eleece Doll
• Samantha Donaldson

• Gerontology Nurse Practitioner in Conway, SC
• Providers in Conway, SC by specialty
• Gerontology Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.