TIFFANY LACK APRN, FNP-BC
NPI 1700431723
Nurse Practitioner - Family in Maumelle, AR

Active since August 06, 2019PECOS EnrolledAccepts Medicare Assignment
2001 CLUB MANOR DR STE S, MAUMELLE, AR 72113(501) 734-8085(501) 734-8085 Get Directions Write a Review

NPPES record last updated: April 24, 2024. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Apr 24, 2024, Jan 25, 2021, Feb 20, 2020 and 1 more (4 updates tracked since 2019).

About Tiffany Lack Aprn, Fnp-bc NPPES

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

TIFFANY LACK APRN, FNP-BC (NPI 1700431723) is an individual family provider in Maumelle, Arkansas, licensed in Arkansas (123569) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1700431723
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTIFFANY LACKCredential: APRN, FNP-BC
Location Address2001 CLUB MANOR DR STE SMaumelle, AR 72113-7417
Mailing Address2001 Club Manor Dr Ste SMaumelle, AR 72113-7417 · (501) 734-8085 · Fax (501) 734-8088
Fax(501) 734-8085
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateAugust 6, 2019
Last NPPES UpdateApril 24, 20244 updates tracked since enumeration
NPPES CertifiedApril 24, 2024
NPI 1700431723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in AR · 123569
2001 CLUB MANOR DR STE S, Maumelle, AR 72113

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Tiffany Lack Aprn, Fnp-bc 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 ID3779913207
PECOS Enrollment IDI20200423001120
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Assessment of emotional or behavioral problems 96127
Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.
95 services35 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
92 services38 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
62 services33 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
40 services40 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
17 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72113 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$79.72 typical visit price
range $51.36 – $157.74
Typical copayment $19.93 (range $12.84 – $39.43)
Most-billed visit code 99203
Established Patient
$91.63 typical visit price
range $16.16 – $128.77
Typical copayment $22.90 (range $4.04 – $32.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

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

Nurse Practitioner (Family)
2001 CLUB MANOR DR STE S
MAUMELLE, AR 72113
Nurse Practitioner
2001 CLUB MANOR DR STE S
MAUMELLE, AR 72113
Nurse Practitioner (Psychiatric/Mental Health)
2001 CLUB MANOR DR STE S
MAUMELLE, AR 72113
Family Medicine
2001 CLUB MANOR DR STE S
MAUMELLE, AR 72113

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 Lack's NPI number?

The NPI number for Tiffany Lack is 1700431723. It was assigned to this individual provider in the NPPES registry on August 6, 2019.

Where is Tiffany Lack located?

Tiffany Lack practices at 2001 Club Manor Dr Ste S, Maumelle, AR 72113. The listed phone number is (501) 734-8085.

What is Tiffany Lack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Tiffany Lack enrolled in Medicare?

Yes. Tiffany Lack 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.

What insurance does Tiffany Lack accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 5 other insurers list Tiffany Lack as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tiffany Lack was last updated on April 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.