NPIMap

Individual provider Active NPI

Tiffany Smith, MD

  • Family Medicine Physician
  • Grand Junction, CO
National Provider Identifier
1235797713
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0066555 Issued in CO
Practice address
2478 Patterson Rd Ste 27
Grand Junction, CO 81505-3606
Phone
(970) 644-4300
Fax
(970) 263-4323
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TL0007547 CO
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X DR.0066555 CO Primary

Addresses

Primary practice location

2478 Patterson Rd Ste 27
Grand Junction, CO 81505-3606

Mailing address

PO Box 1727
Grand Junction, CO 81502-1727
Phone (970) 644-4300

Other identifiers 1

IdentifierTypeStateIssuer
9000173588MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20220912003784 CO Practitioner - Family Practice 9537494422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Group LLCGroup PAC ID 1052612785, 109 clinicians

Practice addresses (Care Compare)

2478 Patterson Rd
Suite 27
Grand JCT, CO 81505-3606
Phone (970) 644-4300

Hospital & facility affiliations

  • Community Hospital Hospital, Grand Junction, CO, CCN 060054
  • Intermountain Health St. Mary'S Regional Hospital Hospital, Grand Junction, CO, CCN 060023

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL0007547COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Group, LLC CurrentSince Sep 1, 2022 Accepting new patients
Community Medical Group, LLC Current Accepting new patients
Community Medical Group, LLC CurrentSince Sep 1, 2022 Accepting new patients
Community Medical Group Past Accepting new patients
Community Medical Group, LLC Family Medicine Past Accepting new patients
Community Medical Group, LLC Family Medicine Past Accepting new patients

Locations

101 Jurassic Ave
Unit B
Fruita, CO 81521
Phone (970) 858-6677

2478 Patterson Rd
Ste 27
Grand Junction, CO 81505
Phone (970) 257-1862

731 Iowa Ave
Ste A
Palisade, CO 81526
Phone (970) 644-4050

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1235797713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1727",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815021727",
            "telephone_number": "970-644-4300",
            "fax_number": "970-263-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2478 PATTERSON RD STE 27",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815053606",
            "telephone_number": "970-644-4300",
            "fax_number": "970-263-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TIFFANY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "TL0007547",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0066555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000173588",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.