Individual provider Active NPI

Tiffany Weston

  • Physical Therapist
  • Bryant, AR
National Provider Identifier
1104522069
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5259 Issued in AR
Practice address
6144 Hwy 5 North
Suite 300
Bryant, AR 72022
Phone
(501) 500-3500
Fax
(501) 904-3620
NPI assigned
Feb 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5259 AR Primary

Addresses

Primary practice location

6144 Hwy 5 North
Suite 300
Bryant, AR 72022

Mailing address

800 Fair Park Blvd
Little Rock, AR 72204-1720
Phone (501) 404-8007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230301000275 AR Practitioner - Physical Therapist in Private Practice 1557734209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pro Active Rehab, IncGroup PAC ID 2668482340, 15 clinicians
Orthoarkansas PAGroup PAC ID 1456256031, 148 clinicians

Practice addresses (Care Compare)

1308 Military Rd
Benton, AR 72015-2911
Phone (501) 776-1885

6144 Hwy 5 N
Suite 300
Bryant, AR 72022
Phone (501) 500-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5259ARMDPhysical Therapist

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1104522069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041720",
            "telephone_number": "501-404-8007",
            "fax_number": "501-904-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6144 HWY 5 NORTH",
            "address_2": "SUITE 300",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "72022",
            "telephone_number": "501-500-3500",
            "fax_number": "501-904-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTON",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-02",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "5259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryant, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.