Individual provider

TRICIA M MIEDEMA, MD

CMS NPPES lists TRICIA M MIEDEMA as an individual provider record with NPI 1023390507. The current record reports a primary practice location in AFTON, WY and primary taxonomy code 207P00000X.

NPI 1023390507Record type Type 1Primary taxonomy 207P00000X

Type 1 NPIs identify individual healthcare providers. How to read this profile

01

Practice locations

  1. Primary practice location
    901 ADAMS STAFTON, WY 831109621

Only source-designated practice locations are shown here. Mailing addresses are not presented as practice locations.

02

Taxonomy information

  • 363A00000XAdditional reported taxonomy
  • 207P00000XPrimary reported taxonomy

Taxonomy codes describe provider classifications reported to NPPES. Repeated identical codes are shown once, with primary-reported status preserved. They are not licenses, certifications, quality measures, or NPIFolio specialty labels. Read the taxonomy methodology.

03

NPI record information

NPI status
Enumerated in NPPES
Enumeration date
September 12, 2011

An NPI is a federal identifier. Enumeration and lifecycle information does not establish medical-license status, current practice, disciplinary history, provider quality, or whether a provider is accepting patients.