Individual provider Active NPI

Tiffany Ryskamp Wightman, PA C

  • Physician Assistant
  • Hickory, NC
National Provider Identifier
1851443436
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1000889 Issued in NC
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

Updated by the provider on Jul 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
0889NCMDOptometrist
1000889NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Associates, PA CurrentSince Jun 1, 2007 Accepting new patients

Locations

1985 Tate Blvd SE
Ste 600
Hickory, NC 28602
Phone (828) 328-5500

Interoperability endpoints

  • FHIR API: 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.

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.

Verify at the official NPI Registry.