Active NPI
Tiffany Ryskamp Wightman, PA C
- Physician Assistant
- Hickory, NC
National Provider Identifier
1851443436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1000889
- Practice address
- 1985 Tate Blvd SE
Suite 600
Hickory, NC 28602-1498 - Phone
- (828) 328-5500
- Fax
- (828) 485-2517
- NPI assigned
- Jan 17, 2007
- 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 | 1000889 | NC | Primary |
Addresses
Primary practice location
1985 Tate Blvd SE
Suite 600
Hickory, NC 28602-1498
Mailing address
1985 Tate Blvd SE
Suite 600
Hickory, NC 28602-1498
Phone (828) 328-5500
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0889 | NC | MD | Optometrist |
| 1000889 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurology Associates, PA | Current | Accepting new patients |
Locations
1985 Tate Blvd SE
Ste 600
Hickory, NC 28602
Phone (828) 328-5500
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CFIHAA
Organizations & group practices 1
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.
-
- Specialist
- Hickory, NC
- NPI 1083722482
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404950400000",
"number": "1851443436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1985 TATE BLVD SE",
"address_2": "SUITE 600",
"city": "HICKORY",
"state": "NC",
"postal_code": "286021498",
"telephone_number": "828-328-5500",
"fax_number": "828-485-2517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1985 TATE BLVD SE",
"address_2": "SUITE 600",
"city": "HICKORY",
"state": "NC",
"postal_code": "286021498",
"telephone_number": "828-328-5500",
"fax_number": "828-485-2517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGHTMAN",
"first_name": "TIFFANY",
"middle_name": "RYSKAMP",
"credential": "PA C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2014-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "1000889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hickory, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.