Tiffani Lynette Dorn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

004253 Issued in OH

Practice address

919 Glyn Evans CT
Newark, OH 43055-1792

Phone

(740) 405-5120

Fax

(740) 788-8268

NPI assigned

Feb 20, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, MI, IL, NY, PA, IN6 enrollments

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 6

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Pic Indiana PCGroup PAC ID 3476790239, 143 clinicians

Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment Care Compare group
• Pic Indiana PC

  dba WellNow Urgent Care

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1942546890

  MI

  Medicare reassignment Care Compare group
• Wellnow Urgent Care, PC

  dba WellNow Urgent Care

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1669825162

  IL, PA

  Medicare reassignment Care Compare group
• Hometown Urgent Care of Michigan, P.C.

  dba Hometown Urgent Care

  • Urgent Care Clinic/Center
  • Huber Heights, OH
  • NPI 1790030385

  MI

  Medicare reassignment NPD
• Hometown Urgent Care of Michigan, P.C.

  dba WellNow Clinical Laboratory

  • Clinical Medical Laboratory
  • Kalamazoo, MI
  • NPI 1891469631
  NPD
• Hometown Urgent Care of Michigan, PC

  dba WellNow Clinical Laboratory

  • Clinical Medical Laboratory
  • Indianapolis, IN
  • NPI 1881358489
  NPD

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

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1629460183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 GLYN EVANS CT",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551792",
            "telephone_number": "740-405-5120",
            "fax_number": "740-788-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 GLYN EVANS CT",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551792",
            "telephone_number": "740-405-5120",
            "fax_number": "740-788-8268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORN",
        "first_name": "TIFFANI",
        "middle_name": "LYNETTE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-20",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7562-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA006586",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008370",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027353",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "004253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie J Dold
• Carlos B Domingo, M.D.
• Ginger Sky Donavan, L.P.N.
• Sierra Elizabeth Donley
• Richard Reed Donnard, DO
• Sarah Dorsky, FNP-C
• Mark Paul Doughty, ATC
• Mary Dow, QBHS
• Hannah Elizabeth Dowalter
• Erika Taylor Downs, D.C.

• Physician Assistant in Newark, OH
• Providers in Newark, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.
• 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.