Tiffany Christiansen, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 623 Issued in ID

Practice address

150 Shoup Ave Ste 17
Idaho Falls, ID 83402-3653

Phone

(208) 528-5892

Fax

(208) 528-5747

NPI assigned

Oct 11, 2006

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

Medicare fee-for-service enrollment

Enrolled in ID

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• State of Idaho Department of Health and Welfare

  • Clinic/Center
  • Blackfoot, ID
  • NPI 1538225545
  NPD
• State of Idaho Department of Health and Welfare

  • Psychiatric Hospital
  • Orofino, ID
  • NPI 1598831653
  NPD

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093803157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SHOUP AVE STE 17",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023653",
            "telephone_number": "208-528-5892",
            "fax_number": "208-528-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SHOUP AVE STE 17",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023653",
            "telephone_number": "208-528-5892",
            "fax_number": "208-528-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIANSEN",
        "first_name": "TIFFANY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA 623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Christensen, LCSW
• Stephanie M Christensen, APRN
• Wade K Christensen, P.A.
• Brian Christenson
• Samuel Jacob Christiansen, BS
• Lesli D. Christofferson, MSN, FNP-BC
• George Chudleigh, PT
• Allison Michelle Chuirazzi, OTR/L
• Cibrian Counseling & Wellness Center, LLC
• Rocco P Cifrese, MD

• Physician Assistant in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.