Tiffany M Wilson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

271375 Issued in AZ

Practice address

20542 N Lake Pleasant Rd Ste 115
Peoria, AZ 85382-9749

Phone

(623) 476-5820

NPI assigned

Aug 27, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twilson227271@pdshealth.direct-ci.com

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.

• Peoria Urgent Care and Walk in Clinic PLLC

  • Urgent Care Clinic/Center
  • Peoria, AZ
  • NPI 1093439762
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1356018204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20542 N LAKE PLEASANT RD STE 115",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829749",
            "telephone_number": "623-476-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20542 N LAKE PLEASANT RD STE 115",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829749",
            "telephone_number": "623-476-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "271375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "unk",
            "affiliation": "N",
            "address_1": "15778 W Yuma Rd",
            "city": "Goodyear",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853383358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hyon Su Wilson, ACNPC-AG
• Nicole Wilson, COTA/L
• Sara A Wilson, PA-C
• Stephanie Marie Wilson
• Susan Ann Wilson, RN, BSN
• Ciandra Winkels
• Courtney Nicole Winters, PA
• Hal Robert Winters, DC
• Samantha Ashlee Wirth, DNP, FNP-BC, FNP-C
• Margaret Ann Withrow, D.P.M.

• Family Nurse Practitioner in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.