Tigist Tadesse Fiyisa

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2475789 Issued in MN

Practice address

5650 Upper 179TH St W # NA
Lakeville, MN 55044-4930

Phone

(651) 235-8272

NPI assigned

Oct 21, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1477217800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 UPPER 179TH ST W # NA",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550444930",
            "telephone_number": "651-235-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5650 UPPER 179TH ST W # NA",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550444930",
            "telephone_number": "651-235-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIYISA",
        "first_name": "TIGIST",
        "middle_name": "TADESSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2475789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE NUMBER",
            "identifier": "2475789",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Ferree
• Victoria Lynn Fett, LGSW
• Carlos E Figari, MD
• Jacob John Filkins, D.C.
• Stacie M Fischer
• Paige Avery Flicek
• Natasha Flores
• Focused Eye Care, PA
• Brian John Foley
• Scott Fontana, O.D.

• Registered Nurse in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.