NPIMap

Organization Active NPI

Tiffany Nelson MD PLC

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1477524916
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TIFFANY NELSON MD PLC
Practice address
20940 N Tatum Blvd
#300
Phoenix, AZ 85050-4265
Phone
(480) 607-0060
Fax
(480) 607-5809
NPI assigned
Feb 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Authorized official

Name
Dr. Tiffany M Nelson, MDNPI 1265413033
Title
Manager
Phone
(480) 607-0060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

20940 N Tatum Blvd
#300
Phoenix, AZ 85050-4265

Mailing address

20940 N Tatum Blvd
#300
Phoenix, AZ 85050-4265
Phone (480) 607-0060

Other names 1

  • Desert Ridge Family Physicians Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040719001494 AZ Part B Supplier - Clinic/Group Practice 9436138708 Receives reassigned benefits from 10 practitioners
Practice locations: Phoenix, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D1029371Tiffany Nelson, MD PLC Dba20940 N Tatum Blvd, Ste 300, Phoenix, AZ 85050Provider-performed microscopyAug 15, 2026

National Provider Directory

National Provider Directory

Locations

20940 N Tatum Blvd
Ste 300
Phoenix, AZ 85050
Phone (480) 607-0060

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/29438/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422403200000",
    "number": "1477524916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20940 N TATUM BLVD",
            "address_2": "#300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504265",
            "telephone_number": "480-607-0060",
            "fax_number": "480-607-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20940 N TATUM BLVD",
            "address_2": "#300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504265",
            "telephone_number": "480-607-0060",
            "fax_number": "480-607-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFFANY NELSON MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2015-01-28",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-607-0060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Ridge Family Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.