Active NPI
Tiffany Desvigne
- Peer Specialist
- Albuquerque, NM
National Provider Identifier
1891563375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 1309
- Practice address
- 203 California St NE
Albuquerque, NM 87108-1802 - Phone
- (505) 308-8296
- Fax
- (505) 433-5096
- NPI assigned
- Dec 14, 2023
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 1309 | NM | Primary |
Addresses
Primary practice location
203 California St NE
Albuquerque, NM 87108-1802
Mailing address
203 California St NE
Albuquerque, NM 87108-1802
Phone (505) 308-8296
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1309 | NM | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702512000000",
"number": "1891563375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "203 CALIFORNIA ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871081802",
"telephone_number": "505-308-8296",
"fax_number": "505-433-5096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 CALIFORNIA ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871081802",
"telephone_number": "505-308-8296",
"fax_number": "505-433-5096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESVIGNE",
"first_name": "TIFFANY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-14",
"last_updated": "2023-12-14",
"certification_date": "2023-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NM",
"license": "1309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.