TIFFANY FAWN BOGGS — NPI 1922822105 (Licensed & Credentialed Case Manager/Care Coordinator in CLEARLAKE OAKS, CA)

CMS-1500 Box 24J / 33a • NPI

1922822105

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

171M00000X

Licensed & Credentialed Case Manager/Care Coordinator

Box 32 Service Location & ZIP+4

14715 E. HWY 20, 14725 CATHOLIC CHURCH RD., CLEARLAKE OAKS, CA, 95423-9542

✓ 9-Digit EDI 837 ZIP+4 (95423-9542)

Practice Phone & Referral Fax

(707) 998-1800

Fax: (707) 998-0122

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1922822105 (TIFFANY FAWN BOGGS) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1922822105` (NPI-1 Individual Practitioner)
Provider / Legal Name	TIFFANY FAWN BOGGS
Plain-English Specialty	Licensed & Credentialed Case Manager/Care Coordinator NUCC Code: `171M00000X` (Case Manager/Care Coordinator)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	14715 E. HWY 20, 14725 CATHOLIC CHURCH RD., CLEARLAKE OAKS, CA, 95423-9542
Practice Telephone / Fax	Tel: (707) 998-1800 \| Fax: (707) 998-0122
Administrative Mailing Address	PO BOX 316, LUCERNE, CA, 95458-0316
Enumeration & Last Sync	Enumerated: 2024-11-13 \| CMS Record Updated: 2026-03-24

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

14715 E. HWY 20, 14725 CATHOLIC CHURCH RD., CLEARLAKE OAKS, CA, 95423-9542

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Plain-English Taxonomy & CMS Crosswalk (171M00000X)

What Does Taxonomy Code 171M00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 171M00000X translates to:
"Licensed & Credentialed Case Manager/Care Coordinator"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Case Manager/Care Coordinator for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (TIFFANY FAWN BOGGS)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`175T00000X` — Peer Specialist Plain English: Licensed & Credentialed Peer Specialist	State: CA \| License: `MPSS-QASLME` \| Primary: Secondary
`172V00000X` — Community Health Worker Plain English: Licensed & Credentialed Community Health Worker	State: CA \| License: `Verified` \| Primary: Secondary
`171M00000X` — Case Manager/Care Coordinator Plain English: Licensed & Credentialed Case Manager/Care Coordinator	State: CA \| License: `mpss-qaslme` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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TIFFANY FAWN BOGGS (NPI #1922822105)