Tiffany L Vardon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004741 Issued in MI

Practice address

200 Jefferson Ave SE
6 South #626
Grand Rapids, MI 49503-4502

Phone

(616) 685-5039

Fax

(616) 685-8910

NPI assigned

Jun 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tiffany L Woods Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advantage Health/Saint Mary's Medical GroupGroup PAC ID 4082807961, 499 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tvardon36808@direct.trinity-health.org

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.

• Advantage Health/Saint Mary's Medical Group

  dba Trinity Health Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment Care Compare group
• Advantage Health Saint Mary's Medical Group

  dba Trinity Health Medical Group Orthopedics Grand Rapids

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008

  Physician Assistant

  NPD
• Trinity Health - Michigan

  dba Heartside Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Grand Rapids, MI
  • NPI 1902002272
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1891738928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 STATE ST SE",
            "address_2": "STE 1A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034328",
            "telephone_number": "616-685-1808",
            "fax_number": "616-913-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "address_2": "6 SOUTH #626",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-685-5039",
            "fax_number": "616-685-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARDON",
        "first_name": "TIFFANY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "WOODS",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristin Marie Vanzanten, CTRS
• Aaron Vanzee, MD
• Rebekah Vanzegren, PT
• Pooja Lakshmi Varanasi
• Darryl John Varda, MD
• Cristal Vargas Castillo
• Jessica Bryan Vargas, LPN
• Willedia Vargas
• Candace Susan Vargo, RPH
• Michael C Vargo, PHD

• Physician Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.