NPIMap

Individual provider Active NPI

Tiffany Venne, ATC, PA-C

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1114372349
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1000 E 1St St
Ste 404
Duluth, MN 55805-2297
Phone
(218) 722-5513
NPI assigned
Apr 25, 2016
Last updated
Jan 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Athletic Trainer 2255A2300X NU

Addresses

Primary practice location

1000 E 1St St
Ste 404
Duluth, MN 55805-2297

Mailing address

1000 E 1St St
Ste 404
Duluth, MN 55805-2297
Phone (218) 722-5513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210316001298 MN Practitioner - Physician Assistant 4284040379 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Associates of Duluth PAGroup PAC ID 1951294065, 37 clinicians
Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians
Range Regional Health ServicesGroup PAC ID 8022920024, 349 clinicians

Practice addresses (Care Compare)

1000 E 1St St
Duluth, MN 55805-2297
Phone (218) 722-5513

111 SE 3Rd St
Grand Rapids, MN 55744-3663
Phone (218) 326-3401

1601 Golf Course Rd
Grand Rapids, MN 55744-8648
Phone (218) 326-3401

402 E Platt Ave
Nashwauk, MN 55769-1147
Phone (218) 885-2858

512 Skyline Blvd
Cloquet, MN 55720-3787
Phone (218) 879-4641

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Hospital Association CurrentSince Jun 1, 2024 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Apr 1, 2021 Accepting new patients
Range Regional Health Services CurrentSince Apr 30, 2021 Accepting new patients
Range Regional Health Services CurrentSince Apr 30, 2021 Accepting new patients

Locations

512 Skyline Blvd
Cloquet, MN 55720
Phone (218) 878-7207

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

1601 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3401

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

Interoperability endpoints

  • Direct secure messaging: tvenne597276@fairview.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1114372349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 1ST ST",
            "address_2": "STE 404",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052297",
            "telephone_number": "218-722-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 1ST ST",
            "address_2": "STE 404",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052297",
            "telephone_number": "218-722-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENNE",
        "first_name": "TIFFANY",
        "credential": "ATC, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-25",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.