Individual provider Active NPI

Tiffany Failla, PHARM D

  • Pharmacist
  • Windom, MN
National Provider Identifier
1104222306
Registry record updated Nov 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
121660 Issued in MN
Practice address
2155 1St Ave N
Windom, MN 56101-1286
Phone
(507) 831-0263
NPI assigned
Nov 15, 2014
Last updated
Nov 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 121660 MN Primary
Pharmacist 183500000X 12674 NE

Addresses

Primary practice location

2155 1St Ave N
Windom, MN 56101-1286

Mailing address

2155 1St Ave N
Windom, MN 56101-1286
Phone (507) 831-0263

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
12674NEMDClinical Social Worker
121660MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1416009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416009600000",
    "number": "1104222306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 1ST AVE N",
            "city": "WINDOM",
            "state": "MN",
            "postal_code": "561011286",
            "telephone_number": "507-831-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 1ST AVE N",
            "city": "WINDOM",
            "state": "MN",
            "postal_code": "561011286",
            "telephone_number": "507-831-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAILLA",
        "first_name": "TIFFANY",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-15",
        "last_updated": "2014-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "121660",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "12674",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windom, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2014; 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.