Individual provider Active NPI

Tiffany Jenann Hallmark

  • Physician Assistant
  • Clyde, NC
National Provider Identifier
1295326536
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11 Falcon Crest LN
Clyde, NC 28721-6620
Phone
(828) 565-0560
NPI assigned
Jan 29, 2021
Last updated
Jul 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NC Primary
Student in an Organized Health Care Education/Training Program 390200000X NC

Addresses

Primary practice location

11 Falcon Crest LN
Clyde, NC 28721-6620

Mailing address

11 Falcon Crest LN
Clyde, NC 28721-6620
Phone (828) 565-0560

Other practice location 1

600 Alliance Ct Ste 200
Asheville, NC 28806-5001
Phone (828) 565-0560

Other names 1

  • Tiffany Jenann James Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220921001215 NC Practitioner - Physician Assistant 1254716616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Laurel Dermatology PLLCGroup PAC ID 4486873098, 5 clinicians

Practice addresses (Care Compare)

11 Falcon Crest LN
Clyde, NC 28721-6620
Phone (828) 565-0560

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.39 of 100Reported as apm
Quality
77.7
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Laurel Dermatology, PLLC CurrentSince Feb 24, 2025 Accepting new patients

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 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": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1295326536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 FALCON CREST LN",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287216620",
            "telephone_number": "828-565-0560",
            "fax_number": "828-565-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 FALCON CREST LN",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287216620",
            "telephone_number": "828-565-0560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Alliance Ct Ste 200",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288065001",
            "country_code": "US",
            "telephone_number": "828-565-0560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALLMARK",
        "first_name": "TIFFANY",
        "middle_name": "JENANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "JAMES",
            "middle_name": "JENANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clyde, NC

Sources for this page

Verify at the official NPI Registry.