Individual provider Active NPI

Tiffany Louise Polley, RN

  • Registered Nurse
  • Gilbert, AZ
National Provider Identifier
1063899920
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN181584 Issued in AZ
Practice address
3507 S Ranch House Pkwy
Gilbert, AZ 85297-4945
Phone
(480) 279-8200
Fax
(480) 279-8205
NPI assigned
Apr 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN181584 AZ Primary

Addresses

Primary practice location

3507 S Ranch House Pkwy
Gilbert, AZ 85297-4945

Mailing address

3820 E Esplanade Ave
Gilbert, AZ 85297-5404
Phone (480) 433-1921

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN181584AZMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1063899920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 E ESPLANADE AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852975404",
            "telephone_number": "480-433-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3507 S RANCH HOUSE PKWY",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852974945",
            "telephone_number": "480-279-8200",
            "fax_number": "480-279-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLEY",
        "first_name": "TIFFANY",
        "middle_name": "LOUISE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN181584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.