TIFFANY L LATTIMORE (NPI# 1699104315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699104315 |
| Entity Type | Individual |
| Full Name | TIFFANY L LATTIMORE |
| Other Name | TIFFANY L MEDLER |
| Credential | PA |
| Practice Address |
8354 100th Ave Stanwood MI 49346-8344 |
| Mailing Address |
100 Michigan St Ne Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 2319726000 |
| Mailing Telephone | 6164866790 |
| Mailing Fax Number | 6164866702 |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2018-04-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601006795 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8354 100TH AVE |
| City | STANWOOD |
| State | MI |
| Zip Code | 49346-8344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730748609 | Katelin Anne Aris | Nurse Practitioner | 8354 100th Ave, Stanwood, MI 49346-8344 | 2019-06-13 |
| 1942693106 | Mecosta County Medical Center | Social Worker | 8354 100th Ave, Stanwood, MI 49346-8344 | 2015-03-12 |
| 1881620359 | Michelle Rose Godfrey | Physician Assistant | 8354 100th Ave, Suite 1, Stanwood, MI 49346-8344 | 2006-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114134681 | Gregerson Radiology Consultants Ltd. | Chiropractor | 8004 Red Fox Rd, Stanwood, MI 49346 | 2007-05-16 |
| 1073969960 | Spine By Design Inc. | Chiropractor | 10032 Buchanan Rd, Stanwood, MI 49346 | 2016-05-10 |
| 1477973493 | Mecosta County Medical Center | Clinic/Center | 8354 100th Ave Ste 1, Canadian Lakes, MI 49346-8345 | 2014-04-17 |
| 1326205030 | Brian Lee Potter | Physical Therapist | 8354 100th Ave Ste 2, Canadian Lakes, MI 49346-8345 | 2008-05-20 |
| 1467906461 | Sandra Hansen | Technician, Other | 9610 Pere Marquette Dr, Stanwood, MI 49346-8359 | 2016-08-08 |
| 1255877965 | Michael Jerome Bausano | Social Worker | 6713 Sunset Ln, Canadian Lakes, MI 49346-8832 | 2017-01-19 |
| 1730299199 | Lois P. Brooks | Psychologist | 6977 Abbey Ln, Stanwood, MI 49346-8994 | 2006-08-30 |
| 1659458255 | L. P. Brooks, Ed.d., Pllc | Psychologist | 6977 Abbey Ln, Stanwood, MI 49346-8994 | 2006-11-01 |
| 1619274669 | Country Living Adult Foster Care | Assisted Living Facility | 16966 6 Mile Rd, Stanwood, MI 49346-9104 | 2011-02-26 |
| 1306334362 | Kyle Hansen | Physical Therapist | 18397 11 Mile Rd, Stanwood, MI 49346-9557 | 2018-04-25 |
| Find all providers in zip 49346 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295127124 | Sonja Brandstrom | Physician Assistant | 10101 270th St Nw, Stanwood, WA 98292-8090 | 2015-03-02 |
| 1356794432 | Jack Eisaman | Physician Assistant | 9631 269th St Nw, Stanwood, WA 98292-8071 | 2016-07-13 |
| 1922177088 | Chris Gustafson | Physician Assistant | 7205 265th St Nw, Stanwood, WA 98292-6221 | 2006-11-06 |
| 1881620359 | Michelle Rose Godfrey | Physician Assistant | 8354 100th Ave, Suite 1, Stanwood, MI 49346-8344 | 2006-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022331 | Anna Lynn Shrift | Physician Assistant | 849 Black Hill Ln, Traverse City, MI 49696-8674 | 2020-10-27 |
| 1972102556 | Aaron Buckley | Physician Assistant | 567 Saint Louis St, Ferndale, MI 48220-2436 | 2020-10-23 |
| 1013516194 | Rebecca Mary Cronin | Physician Assistant | 4311 Kingsbrook Dr, Kalamazoo, MI 49006-3909 | 2020-10-20 |
| 1801495023 | Keriah Khairi Abd | Physician Assistant | 42836 Bloomingdale Dr, Sterling Heights, MI 48314-2843 | 2020-10-19 |
| 1154929016 | Angela Varghese | Physician Assistant | 461 Tanner Dr, Troy, MI 48085-4714 | 2020-10-13 |
| 1861090730 | Maloree Blayke Perkins | Physician Assistant | 20717 Coventry St, Clinton Twp, MI 48035-1603 | 2020-10-13 |
| 1801494000 | Sarah Puchala Lucero | Physician Assistant | 25614 Wilson Dr, Dearborn Heights, MI 48127-3427 | 2020-10-12 |
| 1871191007 | Julia Marie Tucker | Physician Assistant | 12250 E Ridge Dr, Bruce Twp, MI 48065-2011 | 2020-10-10 |
| 1164020301 | Sara Whitneyann Vandeman | Physician Assistant | 7901 S 12th St Ste 101, Portage, MI 49024-3831 | 2020-10-10 |
| 1831796267 | Jowharh Zindani | Physician Assistant | 12020 Mitchell St, Hamtramck, MI 48212-2722 | 2020-10-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.