Individual provider Active NPI

Tiffany Neary, PA-C

  • Medical Physician Assistant
  • Denver, CO
National Provider Identifier
1669827929
Registry record updated Apr 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA0004484 Issued in CO
Practice address
3600 Havana St
Denver, CO 80239-3266
Phone
(303) 307-2320
NPI assigned
Apr 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA0004484 CO Primary

Addresses

Primary practice location

3600 Havana St
Denver, CO 80239-3266

Mailing address

3600 Havana St
Denver, CO 80239-3266
Phone (303) 307-2320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA0004484COMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1461456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461456000000",
    "number": "1669827929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 HAVANA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802393266",
            "telephone_number": "303-307-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 HAVANA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802393266",
            "telephone_number": "303-307-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEARY",
        "first_name": "TIFFANY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-24",
        "last_updated": "2016-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA0004484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2016; 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.