NPIMap

Individual provider Active NPI

Tiffany Dawn Taylor, MPA

  • Physician Assistant
  • Grand Junction, CO
National Provider Identifier
1336797117
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0006832 Issued in CO
Practice address
3150 N 12TH St
Grand Junction, CO 81506-2863
Phone
(970) 256-5201
Fax
(970) 256-5202
NPI assigned
Aug 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0006832 CO Primary

Addresses

Primary practice location

3150 N 12TH St
Grand Junction, CO 81506-2863

Mailing address

PO Box 10700
Grand Junction, CO 81502-5517
Phone (970) 254-2642

Other names 1

  • Tiffany Dawn Petersen Former name

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
I20210713001172 CO Practitioner - Physician Assistant 2769884899 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
Telehealth
Offers telehealth services
Group practices
Primary Care Partners IncGroup PAC ID 7810893161, 58 clinicians

Practice addresses (Care Compare)

3150 N 12TH St
Grand Junction, CO 81506-2863
Phone (970) 245-1220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0006832COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Partners, Inc. Family Medicine CurrentSince Aug 2, 2021 Accepting new patients
Primary Care Partners, Inc. Past Accepting new patients
Primary Care Partners, Inc. Family Medicine Past Accepting new patients

Locations

3150 N 12th St
Grand Junction, CO 81506
Phone (970) 243-5437

Interoperability endpoints

  • Direct secure messaging: tiffanypetersen@pcp.allscriptsdirect.net

Organizations & group practices 3

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 6

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": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1336797117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10700",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815025517",
            "telephone_number": "970-254-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N 12TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815062863",
            "telephone_number": "970-256-5201",
            "fax_number": "970-256-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TIFFANY",
        "middle_name": "DAWN",
        "credential": "MPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "PETERSEN",
            "middle_name": "DAWN",
            "credential": "MPA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.