Individual provider Active NPI

Tiffany Ann Williams, FNP-C

  • Nurse Practitioner
  • Meridian, ID
National Provider Identifier
1275335200
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3871146 Issued in ID
Practice address
2667 E Gala CT Ste 110
Meridian, ID 83642-2791
Phone
(208) 268-8851
NPI assigned
Mar 27, 2025
Last updated
Mar 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3871146 ID Primary

Addresses

Primary practice location

2667 E Gala CT Ste 110
Meridian, ID 83642-2791

Mailing address

2309 N Claremont Dr
Boise, ID 83702-3018
Phone (208) 250-2162

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260216002908 ID Practitioner - Nurse Practitioner 9335629609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Momentum Medical Group of Idaho LLCGroup PAC ID 2668824608, 8 clinicians

Practice addresses (Care Compare)

8950 W Emerald St
Suite 195
Boise, ID 83704-8296
Phone (208) 999-3034

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3871146IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Health and Hormones Nurse Practitioner CurrentSince Mar 30, 2025 Accepting new patients

Locations

2667 E Gala Ct
Ste 110
Meridian, ID 83642
Phone (208) 268-8851

Organizations & group practices 2

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 7

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": "1743033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1275335200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 N CLAREMONT DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023018",
            "telephone_number": "208-250-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2667 E GALA CT STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422791",
            "telephone_number": "208-268-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "3871146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.