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TIFFANY MICHELLE MACK M.S., CCC-SLP
NPI 1134799307
Speech-Language Pathologist in Virginia Beach, VA

Active since June 29, 2021Accepts Medicare Assignment
4560 PRINCESS ANNE RD, VIRGINIA BEACH, VA 23462(757) 474-1249 Get Directions Write a Review

NPPES record last updated: June 29, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Tiffany Michelle Mack M.s., Ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIFFANY MICHELLE MACK M.S., CCC-SLP (NPI 1134799307) is an individual speech-language pathologist provider in Virginia Beach, Virginia, licensed in Virginia (2202003051) and active in the NPI registry since June 2021. She is a graduate of Other (1996).

NPPES Registry Identity

NPI1134799307
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameTIFFANY MICHELLE MACKCredential: M.S., CCC-SLP
Location Address4560 PRINCESS ANNE RDVirginia Beach, VA 23462-7905
Mailing Address812 Parkview CtVirginia Beach, VA 23456-6301 · (757) 575-5713
Phone(757) 474-1249
Sole ProprietorYes
Medical School CMSOtherGraduated 1996
Enumeration DateJune 29, 2021
NPPES CertifiedJune 29, 2021
✔ NPI 1134799307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in VA · 2202003051
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
4560 PRINCESS ANNE RD, Virginia Beach, VA 23462
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tiffany Michelle Mack M.s., Ccc-slp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2668993734
PECOS Enrollment IDI20250305001727

Medicare Billing Reassignment

Medicare enrollment records show Tiffany Mack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Functional Pathways Preferred Of Tennessee LLC
450 mi
Physical Therapist
10133 SHERRILL BLVD, SUITE 200
Knoxville, TN 37932
  • Reassigned Medicare billing, Virginia enrollment
  • 147 clinicians in this Medicare group
NPI 1841561446 (888) 531-2204

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OUR LADY OF PERPETUAL HELP HEALTH CENTER, INC
Nursing Facility/Intermediate Care Facility
4560 PRINCESS ANNE RD
VIRGINIA BEACH, VA 23462
Virginia Beach City (757) 495-4211
GENESIS HEALTHCARE
Skilled Nursing Facility
4560 PRINCESS ANNE RD
VIRGINIA BEACH, VA 23462
Virginia Beach City (757) 495-4211
RACHEL KASLINER OTR/L
Occupational Therapist
4560 PRINCESS ANNE RD
VIRGINIA BEACH, VA 23462
Virginia Beach City (757) 495-4211
KAYLA LIVESAY FERGUSON M.A., CCC-SLP
Speech-Language Pathologist
4560 PRINCESS ANNE RD
VIRGINIA BEACH, VA 23462
Virginia Beach City (757) 495-4211
MRS. TANYAA SHAREE WILLIAMS COTA
Occupational Therapy Assistant
4560 PRINCESS ANNE RD
VIRGINIA BEACH, VA 23462
Virginia Beach City (757) 474-1249
MISS KATELYN LINSKI
Speech-Language Pathologist
4560 PRINCESS ANNE RD
VIRGINIA BEACH, VA 23462
Virginia Beach City (757) 495-4211
DERREK BAX
Physical Therapy Assistant
4560 PRINCESS ANNE RD
VIRGINIA BEACH, VA 23462
Virginia Beach City (757) 495-4211
AMANDA LLOY HILL LPTA
Physical Therapy Assistant
4560 PRINCESS ANNE RD
VIRGINIA BEACH, VA 23462
Virginia Beach City (757) 495-4211

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tiffany Mack's NPI number?

The NPI number for Tiffany Mack is 1134799307. It was assigned to this individual provider in the NPPES registry on June 29, 2021.

Where is Tiffany Mack located?

Tiffany Mack practices at 4560 Princess Anne Rd, Virginia Beach, VA 23462. The listed phone number is (757) 474-1249.

What is Tiffany Mack's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Tiffany Mack enrolled in Medicare?

Yes. Tiffany Mack is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Tiffany Mack's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tiffany Mack reassigns Medicare benefits to Functional Pathways Preferred Of Tennessee LLC (Knoxville, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tiffany Mack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tiffany Mack was last updated on June 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.