Individual provider Active NPI

Tiffany E Russell, MD

  • Internal Medicine Physician
  • Kingman, AZ
National Provider Identifier
1124254123
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
70496 Issued in AZ
Practice address
2901 N Stockton Hill Rd Ste B
Kingman, AZ 86401-4121
Phone
(928) 880-5771
NPI assigned
Jun 3, 2009
Last updated
Sep 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 70496 AZ Primary
Pediatrics Physician 208000000X 70496 AZ

Addresses

Primary practice location

2901 N Stockton Hill Rd Ste B
Kingman, AZ 86401-4121

Mailing address

2901 N Stockton Hill Rd Ste B
Kingman, AZ 86401-4121

Other names 1

  • Tiffany E Sturgeon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130904000515 CO Practitioner - Family Practice 8921241308
I20231228001874 AZ Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8921241308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Pittsburgh School of Medicine, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

450 W Paseo Redondo
Tucson, AZ 85701-8274

5408 Rattlesnake Dr
Kingman, AZ 86409-4529

PO Box
Suite 3630
Flagstaff, AZ 86003

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
332359AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Healthcare, Inc. Current Accepting new patients
North Country Healthcare, Inc. CurrentSince Dec 1, 2023 Accepting new patients
North Country Healthcare, Inc. CurrentSince Dec 1, 2023 Accepting new patients
North Country Healthcare, Inc. Family Medicine Current Accepting new patients
North Country Healthcare, Inc. Pediatrics Past Accepting new patients

Locations

2920 N 4th St
Flagstaff, AZ 86004
Phone (928) 213-6100

1510 N Stockton Hill Rd
Kingman, AZ 86401
Phone (928) 753-1177

620 Lee St
Winslow, AZ 86047
Phone (928) 288-8700

Interoperability endpoints

  • Direct secure messaging: tiffany.sturgeon.1@15375.direct.athenahealth.com

Organizations & group practices 6

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1124254123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 N STOCKTON HILL RD STE B",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 N STOCKTON HILL RD STE B",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014121",
            "telephone_number": "928-880-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "TIFFANY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "70496",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "70496",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "STURGEON",
            "middle_name": "E",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.