NPIMap

Individual provider Active NPI

Tiffany Jane Tanner, PA-C

  • Medical Physician Assistant
  • Basin, WY
National Provider Identifier
1902131980
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA1142 Issued in WY
Practice address
806 Big Horn Ave W
Basin, WY 82410-9410
Phone
(307) 388-1161
Fax
(609) 250-9938
NPI assigned
Oct 8, 2009
Last updated
Sep 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA1142 WY Primary

Addresses

Primary practice location

806 Big Horn Ave W
Basin, WY 82410-9410

Mailing address

806 Big Horn Ave W
Basin, WY 82410-9410
Phone (307) 388-1161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240318000813 WY Practitioner - Physician Assistant 0941338784 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Park Hospital DistrictGroup PAC ID 7315855624, 85 clinicians

Practice addresses (Care Compare)

424 Yellowstone Ave
Cody, WY 82414-9309
Phone (307) 527-7501

424 Yellowstone Ave
Suite 120
Cody, WY 82414-9311
Phone (307) 578-2904

525 N 5TH St
Basin, WY 82410-5024
Phone (307) 568-3700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.79 of 100Reported as group
Quality
72.82
Promoting interoperability
100
Improvement activities
40
Cost
63.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1142WYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Park Hospital District CurrentSince Jan 9, 2024 Accepting new patients
Cody Regional Health EMS CurrentSince Aug 23, 2023 Accepting new patients
West Park Hospital District CurrentSince Aug 23, 2023 Accepting new patients
Jerry Rand Apmc Past Accepting new patients
West Park Hospital District Past Accepting new patients
West Park Hospital District Past Accepting new patients

Locations

424 Yellowstone Ave
Cody, WY 82414
Phone (307) 578-2903

424 Yellowstone Ave
Ste 120
Cody, WY 82414
Phone (307) 578-2903

707 Sheridan Ave
Cody, WY 82414
Phone (307) 527-7561

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16076/brand/3/csg/1/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1902131980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 BIG HORN AVE W",
            "city": "BASIN",
            "state": "WY",
            "postal_code": "824109410",
            "telephone_number": "307-388-1161",
            "fax_number": "609-250-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 BIG HORN AVE W",
            "city": "BASIN",
            "state": "WY",
            "postal_code": "824109410",
            "telephone_number": "307-388-1161",
            "fax_number": "609-250-9938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "TIFFANY",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-08",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "PA1142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Basin, WY

Sources for this page

Verify at the official NPI Registry.