Individual provider Active NPI

Tiffany Allen

  • Nurse Practitioner
  • Medford, OR
National Provider Identifier
1346849890
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10014265 Issued in OR
Practice address
520 Medical Center Dr Ste 200
Medford, OR 97504-4314
Phone
(541) 930-7222
NPI assigned
Oct 25, 2020
Last updated
Aug 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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 10014265 OR Primary

Addresses

Primary practice location

520 Medical Center Dr Ste 200
Medford, OR 97504-4314

Mailing address

3455 SW US Veterans Hospital Rd
Portland, OR 97239-3076
Phone (541) 494-8311

Other practice location 1

3455 SW US Veterans Hospital Rd
Portland, OR 97239-3076
Phone (541) 494-8311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20230913000642 OR Practitioner - Nurse Practitioner 3476917295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Oregon Health Sciences University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern Oregon Cardiology LLCGroup PAC ID 2264572510, 28 clinicians

Practice addresses (Care Compare)

520 Medical Ctr Dr
Suite 200
Medford, OR 97504-4314
Phone (541) 930-7222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10014265ORMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Oregon Cardiology LLC CurrentSince Aug 7, 2023 Accepting new patients

Locations

520 Medical Center Dr
Ste 200
Medford, OR 97504
Phone (541) 282-6600

Organizations & group practices 1

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": "1603584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1346849890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 SW US VETERANS HOSPITAL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393076",
            "telephone_number": "541-494-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044314",
            "telephone_number": "541-930-7222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3455 SW US Veterans Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393076",
            "country_code": "US",
            "telephone_number": "541-494-8311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-25",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "10014265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.