Tiffany Johnson, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT7592 Issued in TX

Practice address

2601 River Rd
Conestoga, PA 17516-9327

Phone

(717) 842-2321

NPI assigned

Nov 19, 2016

Sex

Female

Sole proprietor

Yes

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, last updated by the provider on Apr 7, 2022.

{
    "created_epoch": "1479513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1669915880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 LANCASTER AVE APT 2",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033310",
            "telephone_number": "302-373-2458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 RIVER RD",
            "city": "CONESTOGA",
            "state": "PA",
            "postal_code": "175169327",
            "telephone_number": "717-842-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TIFFANY",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-19",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT7592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Arters
• Olivia E Asso-Gonzalez
• Conestoga Ambulance Association
• Jesse Glick, PA
• Laura S Hank, LCSW
• Robert Stephen Kayden Jr., R.PH.
• Dana K Leshok, CRNP
• Stacy Lois
• John Benner Peterman III, DMD
• Supportive Pathways Counseling, LLC

• All providers in Conestoga, PA
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.