Individual provider Active NPI

Tiffany T White, PA-C

  • Medical Physician Assistant
  • Annapolis, MD
National Provider Identifier
1972814697
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C05099 Issued in MD
Practice address
2002 Medical Pkwy
Suite 230
Annapolis, MD 21401-3046
Phone
(410) 266-3900
Fax
(410) 266-9245
NPI assigned
Jun 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1560 KY
Medical Physician Assistant 363AM0700X C05099 MD Primary

Addresses

Primary practice location

2002 Medical Pkwy
Suite 230
Annapolis, MD 21401-3046

Mailing address

2002 Medical Pkwy
Suite 230
Annapolis, MD 21401-3046
Phone (410) 266-3900

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1560KYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1972814697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY",
            "address_2": "SUITE 230",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013046",
            "telephone_number": "410-266-3900",
            "fax_number": "410-266-9245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY",
            "address_2": "SUITE 230",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013046",
            "telephone_number": "410-266-3900",
            "fax_number": "410-266-9245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "TIFFANY",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1560",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C05099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.