Individual provider Active NPI

Tiffani Tabish Fries, D.C.

  • Chiropractor
  • Salt Lake City, UT
National Provider Identifier
1114977105
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5005891-1202 Issued in UT
Practice address
1200 E 3300 S
Salt Lake City, UT 84106-2522
Phone
(801) 485-2580
Fax
(801) 485-2587
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5005891-1202 UT Primary

Addresses

Primary practice location

1200 E 3300 S
Salt Lake City, UT 84106-2522

Mailing address

1200 E 3300 S
Salt Lake City, UT 84106-2522
Phone (801) 485-2580

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070809000100 UT Practitioner - Chiropractic 2961502836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1548 E 4500
Suite 101
Salt Lake City, UT 84117-5209
Phone (801) 676-0243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5005891-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Chiropractic, Inc. Chiropractor CurrentSince Mar 10, 2013 Accepting new patients

Locations

1200 E 3300 S
Millcreek, UT 84106
Phone (801) 256-6675

1548 E 4500 S
Ste 101
Millcreek, UT 84117
Phone (801) 676-0243

Networks

  • UT PPO
  • UT PPO D-SNP

Organizations & group practices 1

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1114977105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062522",
            "telephone_number": "801-485-2580",
            "fax_number": "801-485-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062522",
            "telephone_number": "801-485-2580",
            "fax_number": "801-485-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIES",
        "first_name": "TIFFANI",
        "middle_name": "TABISH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "5005891-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.