Shayna M Tisdall, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2350 Issued in CO

Practice address

5200 DTC Pkwy
Suite 400
Greenwood Village, CO 80111-2709

Phone

(303) 745-0000

Fax

(303) 773-3101

NPI assigned

May 11, 2007

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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Philippe G Lopez MD PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Greenwood Village, CO
  • NPI 1871526897
  NPD (past)

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1023223278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 DTC PKWY",
            "address_2": "SUITE 400",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112709",
            "telephone_number": "303-745-0000",
            "fax_number": "303-773-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 DTC PKWY",
            "address_2": "SUITE 400",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112709",
            "telephone_number": "303-745-0000",
            "fax_number": "303-773-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALL",
        "first_name": "SHAYNA",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA2350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31187358",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "019216",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Matthew Tillery
• Steven Alan Tilliss, DDS, MS
• Tim Plucinsky, PLLC
• Holly Timberman
• Russell Chandler Tipton, M.D.
• Elizabeth E Tjeerdsma
• To Each Her Own Women's Health Services Limited
• Susan Tobin, MT
• Lauren Tolcher, M.ED., BCBA
• Marianne Black Toledo, R.N.

• Physician Assistant in Greenwood Village, CO
• Providers in Greenwood Village, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.