Tiffany C Coughenour, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA244 Issued in ID

Practice address

3200 Channing Way
Ste 205
Idaho Falls, ID 83404-7546

Phone

(208) 535-4300

Fax

(208) 535-4315

NPI assigned

Apr 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Eastern Idaho Medical Consultants

  • Internal Medicine Physician
  • Idaho Falls, ID
  • NPI 1326052630
  Medicare reassignment
• Idaho Falls Community Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1114481447
  NPD (past)

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1205959756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2985 CORTEZ AVE",
            "address_2": "STE 200",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047554",
            "telephone_number": "208-535-4300",
            "fax_number": "208-535-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CHANNING WAY",
            "address_2": "STE 205",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047546",
            "telephone_number": "208-535-4300",
            "fax_number": "208-535-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHENOUR",
        "first_name": "TIFFANY",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805523500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Costco Wholesale Corporation (Costco Pharmacy #1379)
• Costco Wholesale Corporation (Costco Optical #1379)
• Costco Wholesale Corporation (Costco Hearing Aid #1379)
• Nathan Dewey Cottle, DO
• Couch Dental Care
• Troy Coulson, PHARMD
• Counseling Center for Children and Families
• Counseling Center of Southeast Idaho
• Bailee Cowan, BSN
• Emily Ann Cowles, R.D.,L.D.

• Physician Assistant in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.