Tiffani D. Showalter, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

964 Issued in AK

Practice address

3883 74TH Avenue NE
Fort Totten, ND 58335

Phone

(701) 766-1600

NPI assigned

Jun 17, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spirit Lake Health Center

  • Health Service Clinic/Center
  • Fort Totten, ND
  • NPI 1073665493
  NPD (past)
• Spirit Lake Tribe

  dba Spirit Lake Health Center

  • Health Service Clinic/Center
  • Fort Totten, ND
  • NPI 1114472891
  NPD (past)

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382054400000",
    "number": "1770804387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "FORT TOTTEN",
            "state": "ND",
            "postal_code": "583350309",
            "telephone_number": "701-766-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 74TH AVENUE NE",
            "city": "FORT TOTTEN",
            "state": "ND",
            "postal_code": "58335",
            "telephone_number": "701-766-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOWALTER",
        "first_name": "TIFFANI",
        "middle_name": "D.",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2013-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA06531",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Robinson
• Jeanette Lucille Rosenheim, RN
• Lena J Salha, D.D.S.
• Cheri J Schaffer, RN
• Jacqueline Patrice Schroeder
• Danielle Rose Silbernagel, DMD
• Spirit Lake Head Start
• Spirit Lake Health Center
• Spirit Lake Health Center
• Spirit Lake Health Center

• Medical Physician Assistant in Fort Totten, ND
• Providers in Fort Totten, ND by specialty
• Medical Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; 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.