Tiffany Witek, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

271520 Issued in AZ

Practice address

1760 E Florence Blvd Ste 100
Casa Grande, AZ 85122-4765

Phone

(520) 374-6505

NPI assigned

Mar 3, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

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.

• Banner Childrens Banner Health Clinic LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1407191216
  Medicare reassignment NPD
• Banner Childrens Banner Health Clinic LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1285278077
  NPD
• Banner Childrens Banner Health Clinic LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1558606020
  NPD

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1396492930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 N KADOTA AVE APT 241",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851222772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 E FLORENCE BLVD STE 100",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224765",
            "telephone_number": "520-374-6505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1298 W Finnie Flat Rd",
            "address_purpose": "LOCATION",
            "city": "Camp Verde",
            "state": "AZ",
            "postal_code": "863225958",
            "country_code": "US",
            "telephone_number": "928-639-5509",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36500 Aurora Dr",
            "address_purpose": "LOCATION",
            "city": "Summit",
            "state": "WI",
            "postal_code": "530664899",
            "country_code": "US",
            "telephone_number": "262-434-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITEK",
        "first_name": "TIFFANY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "11795-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "271520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beyrl E Wilson
• George M Wilson, MSW
• Paul T Wilson, OD
• Jodi Lyn Wilton, M.ED, LISAC, LPC
• Kelly Winnett, NMD
• Richard D. Woolf, PT, CSCS
• Brian Alan Woolford, OD
• Tyrae Word
• Marie Gagne Wright
• Bing Xie, FNP

• Family Nurse Practitioner in Casa Grande, AZ
• Providers in Casa Grande, 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 Jul 15, 2024; 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.