Active NPI
Tiffany S Wilson, DC
- Electroneurodiagnostic Specialist/Technologist
- Colorado Springs, CO
National Provider Identifier
1013686930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Electroneurodiagnostic Specialist/Technologist
- Practice address
- 24 S Weber St Ste 200
Colorado Springs, CO 80903-1928 - Phone
- (866) 226-8576
- NPI assigned
- Sep 13, 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 |
|---|---|---|---|---|
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X | CA | Primary |
Addresses
Primary practice location
24 S Weber St Ste 200
Colorado Springs, CO 80903-1928
Mailing address
7046 Hollywood Blvd Apt 204
Los Angeles, CA 90028-6058
Phone (818) 739-9892
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26-2707834 | Medicaid | CO |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631491200000",
"number": "1013686930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7046 HOLLYWOOD BLVD APT 204",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900286058",
"telephone_number": "818-739-9892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 S WEBER ST STE 200",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809031928",
"telephone_number": "866-226-8576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TIFFANY",
"middle_name": "S",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-13",
"last_updated": "2021-09-13",
"certification_date": "2021-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "246ZE0600X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "26-2707834",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.