Tiffanii Sharee Johnson
Individual provider Active NPI Acute Care Nurse Practitioner · Grantsville, UT
NPI 1104622182 · NPPES record last updated Mar 31, 2026
Key facts
- NPI
- 1104622182
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 8716958-4405 (UT)
- Practice address
- 408 Zachary Way
Grantsville, UT 84029-9777 - Phone
- (435) 830-4936
- NPI assigned
- Feb 20, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Utah Adult Services
Practice addresses (Care Compare)
50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 585-6387
Hospital & facility affiliations
- University of Utah Hospital and Clinics
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260209000674 | UT | Practitioner - Nurse Practitioner | 6901385178 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8716958-4405 | UT | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Adult Services | Current |
Accepting new patients | |
| University of Utah Adult Services | Current |
Accepting new patients |
Locations
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
Interoperability endpoints
- tjohnson557065@direct.med.utah.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 8716958-4405 | UT | |
| Acute Care Nurse Practitioner | 363LA2100X | 8716958-4405 | UT | Yes |
Addresses
Primary practice location
408 Zachary Way
Grantsville, UT 84029-9777
Mailing address
408 Zachary Way
Grantsville, UT 84029-9777
Phone (435) 830-4936
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tjohnson557065@direct.med.utah.edu | Direct | University of Utah |
Other providers in Grantsville, UT
- Integrated Functional Medicine
- Devin Jackson
- Jacie Jelte
- Aleisha Jensen
- Sydnee Johnson
- Jennifer Jones
- Rebecca Jones
- Shane M Juber
- Anita Keetch
- Josseline Kelley
All providers in Grantsville, UT · Acute Care Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.