Tiffany Diann Harders, CPO

Primary specialty

ProsthetistTaxonomy code 224P00000X

License

CPO04209 Issued in NC

Practice address

2016 S Greeley Hwy Unit 16B
Cheyenne, WY 82007-3793

Phone

(307) 316-3098

NPI assigned

Jun 20, 2019

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)

Not enrolled

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.

• Sunshine Prosthetics Inc

  • Customized Equipment (DME)
  • Wilson, NC
  • NPI 1972081800

  Orthotist

  NPD

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1780244897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 DELL RANGE BLVD STE H",
            "address_2": "BOX 265",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094946",
            "telephone_number": "307-316-3098",
            "fax_number": "252-429-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 S GREELEY HWY UNIT 16B",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820073793",
            "telephone_number": "307-316-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDERS",
        "first_name": "TIFFANY",
        "middle_name": "DIANN",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "NC",
            "license": "CPO04209",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "NC",
            "license": "CPO04209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Hansen, LCSW-1457
• Kathleen Hanson-Boyce
• Aileen Sherrin Hanson, PHYSICAL THERAPIST
• Laurie Hanson, OTR/L
• Anna M Harberts, LAT
• Martin L Hardsocg, MA, NCC, PC
• Brian Charles Hardy, M.D.
• Deshann Harewood
• Kaelin Hargraves
• Drew Ann Harlow, DDS

• All providers in Cheyenne, WY
• Prosthetist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.