Individual provider Active NPI

Tiffany Ann Fiscus, PTA

  • Physical Therapy Assistant
  • San Angelo, TX
National Provider Identifier
1699152264
Registry record updated May 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2107358 Issued in TX
Practice address
410 McKee LN
Apartment C4
San Angelo, TX 76904-8437
Phone
(814) 730-9072
NPI assigned
May 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE010212 PA
Physical Therapy Assistant 225200000X 2107358 TX Primary

Addresses

Primary practice location

410 McKee LN
Apartment C4
San Angelo, TX 76904-8437

Mailing address

317 Pleasant Dr
Warren, PA 16365-3351
Phone (814) 730-9072

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
TE010212PAMDPhysical Therapy Assistant
2107358TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1430524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430524800000",
    "number": "1699152264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 PLEASANT DR",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163653351",
            "telephone_number": "814-730-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MCKEE LN",
            "address_2": "APARTMENT C4",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769048437",
            "telephone_number": "814-730-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCUS",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-02",
        "last_updated": "2015-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE010212",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2107358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2015; 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.