Jason Alan Tiede, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

117822 Issued in MO

Practice address

1800 W 30TH St
Joplin, MO 64804-1520

Phone

(417) 782-5000

Fax

(417) 782-2945

NPI assigned

Jul 31, 2006

Sex

Male

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)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629084900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W 30TH ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041520",
            "telephone_number": "417-782-5000",
            "fax_number": "417-782-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W 30TH ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041520",
            "telephone_number": "417-782-5000",
            "fax_number": "417-782-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDE",
        "first_name": "JASON",
        "middle_name": "ALAN",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "117822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0000426956",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda F Thorn
• Tiffany Thornton, LMSW
• Kylee Marie Thorpe
• Anthony Travis Thrower, CRNA
• Austin Thrower, DO
• Alexon Chau Tiem
• James H. Tiemann, M.D.
• Jung Hee Tiffany, RPT
• Maria S Timpe, SLP
• Sandra J Tinney, NP

• Medical Physician Assistant in Joplin, MO
• Providers in Joplin, MO by specialty
• Medical Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.