Individual provider Active NPI

Tiffany Ann Williams, FNP-C

  • Family Nurse Practitioner
  • Blackfoot, ID
National Provider Identifier
1952866063
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
60627 Issued in ID
Practice address
98 Poplar St
Blackfoot, ID 83221-1758
Phone
(208) 785-3897
Fax
(208) 785-9432
NPI assigned
Feb 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 60627 ID Primary

Addresses

Primary practice location

98 Poplar St
Blackfoot, ID 83221-1758

Mailing address

98 Poplar St
Blackfoot, ID 83221-1758
Phone (208) 745-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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

Enrollment IDStateProvider typePAC IDDetails
I20200305002066 ID Practitioner - Nurse Practitioner 6901233550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BMH IncGroup PAC ID 8426149758, shared by 7 NPIs, 137 clinicians
Bingham Memorial HospitalGroup PAC ID 8426955014, 68 clinicians

Practice addresses (Care Compare)

315 W Idaho St
Blackfoot, ID 83221-1711
Phone (208) 782-3990

3302 Valencia Dr
Idaho Falls, ID 83404-7058
Phone (208) 535-3635

98 Poplar St
Blackfoot, ID 83221-1758
Phone (208) 785-4100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BMH Inc CurrentSince Mar 2, 2020 Accepting new patients
BMH, Inc. Current Accepting new patients
BMH, Inc. Family Medicine CurrentSince Mar 2, 2020 Accepting new patients
BMH Inc. Family Medicine CurrentSince Mar 2, 2020 Accepting new patients
BMH Inc. Past Accepting new patients

Locations

3456 E 17th St
Ste 125
Ammon, ID 83406
Phone (208) 529-2828

1350 Parkway Dr
Ste A
Blackfoot, ID 83221

98 Poplar St
Blackfoot, ID 83221
Phone (208) 782-3763

315 W Idaho St
Blackfoot, ID 83221
Phone (208) 782-3990

326 Poplar St
Blackfoot, ID 83221
Phone (208) 785-5801

3302 Valencia Dr
Ste 120
Idaho Falls, ID 83404
Phone (208) 535-3635

3302 Valencia Dr
Ste 201
Idaho Falls, ID 83404
Phone (208) 524-9400

850 Yellowstone Ave
Ste A
Pocatello, ID 83201
Phone (208) 239-8065

4750 Yellowstone Ave
Ste A
Pocatello, ID 83202
Phone (208) 233-1720

850 Yellowstone Ave
Ste B
Pocatello, ID 83201
Phone (208) 239-8066

275 W Locust St
Ste A
Shelley, ID 83274

275 W Locust St
Ste B
Shelley, ID 83274

Interoperability endpoints

  • Direct secure messaging: tiffanywilliams@bmh.medalliesdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1549065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1952866063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-745-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-785-3897",
            "fax_number": "208-785-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-02",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "60627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackfoot, ID

Sources for this page

Verify at the official NPI Registry.