Tiffany Rose Jenkins, MD
Individual provider Active NPI Family Medicine Physician · Whiteriver, AZ
NPI 1962023127 · NPPES record last updated May 17, 2024
Key facts
- NPI
- 1962023127
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD.61341901 (WA)
- Practice address
- PO Box 860
Whiteriver, AZ 85941-0860 - Phone
- (928) 338-4911
- Fax
- (928) 338-5535
- NPI assigned
- Apr 29, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Washington School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DHHS IHS Phoenix Area
Practice addresses (Care Compare)
200 W Hospital Dr
Whiteriver, AZ 85941-0860
Phone 92833849113532
PO Box
Suite 860
Whiteriver, AZ 85941-0860
Hospital & facility affiliations
- Whiteriver PHS Indian Hospital
- Summit Healthcare Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240903001201 | TX | Practitioner - Family Practice | 8022557123 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD.61341901 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS IHS Phoenix Area | Current | Accepting new patients | |
| DHHS IHS Phoenix Area | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD.61341901 | WA | Yes |
Addresses
Primary practice location
PO Box 860
Whiteriver, AZ 85941-0860
Mailing address
PO Box 860
Whiteriver, AZ 85941-0860
Phone (928) 338-4911
Other providers in Whiteriver, AZ
- Michael Ronald Huylebroeck
- James K Ireland
- Frederick Wright Jaeger
- Lia M Jasperse
- Algimantas L Jecius
- Christopher K Jentoft
- Jason Johnson
- Katie Erin Johnson
- Marcus Timothy Johnson
- Troy Lee Johnson
All providers in Whiteriver, AZ · Family Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.