Individual provider Active NPI

Lauren Tiffany Hayden, PA

  • Physician Assistant
  • Johnson City, TN
National Provider Identifier
1093208951
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
403 N State of Franklin Rd Woodridge Hospital
Johnson City, TN 37604
Phone
(423) 340-2276
NPI assigned
Jun 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

403 N State of Franklin Rd Woodridge Hospital
Johnson City, TN 37604

Mailing address

403 N State of Franklin Rd Woodridge Hospital
Johnson City, TN 37604
Phone (423) 340-2276

Other names 1

  • Lauren Tiffany Blankenship Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181210003561 TN Practitioner - Physician Assistant 3476897935
I20190123001438 VA Practitioner - Physician Assistant 3476897935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Ridge Medical Management CorporationGroup PAC ID 9739099441, 283 clinicians

Practice addresses (Care Compare)

1497 W Elk Ave
Elizabethton, TN 37643-2896

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-4847

408 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-4946

Hospital & facility affiliations

  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3641TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation CurrentSince Sep 1, 2018 Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1093208951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 N STATE OF FRANKLIN RD WOODRIDGE HOSPITAL",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-340-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 N STATE OF FRANKLIN RD WOODRIDGE HOSPITAL",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-340-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDEN",
        "first_name": "LAUREN",
        "middle_name": "TIFFANY",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "BLANKENSHIP",
            "middle_name": "TIFFANY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.