Active NPI
Tiffany Butler, PA-C
- Physician Assistant
- Campbell, CA
National Provider Identifier
1801222443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA22996
- Practice address
- 409 Esther Ave
Campbell, CA 95008-1250 - Phone
- (760) 420-9874
- NPI assigned
- Sep 14, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA22996 | CA | Primary |
Addresses
Primary practice location
409 Esther Ave
Campbell, CA 95008-1250
Mailing address
2185 Pacheco Street
Concord, CA 94520-2309
Phone (925) 676-0505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151104002725 | CA | Order and Referring Only - Physician Assistant | 9830409713 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22996 | CA | MD | Clinical Social Worker |
| PA22996 | CA | MD | Physician Assistant |
Interoperability endpoints
- tiffany.butlerpa.p1@direct.ppnorcal.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445904000000",
"number": "1801222443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2185 PACHECO STREET",
"city": "CONCORD",
"state": "CA",
"postal_code": "945202309",
"telephone_number": "925-676-0505",
"fax_number": "866-886-7824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 ESTHER AVE",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "950081250",
"telephone_number": "760-420-9874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "TIFFANY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-14",
"last_updated": "2015-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA22996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Campbell, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.