Individual provider Active NPI

Tiffani Davidson, APRN, DNP

  • Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1013683671
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11014125 Issued in FL
Practice address
1223 Gateway Dr Ste 2E
Melbourne, FL 32901-2607
Phone
(321) 361-5564
NPI assigned
Aug 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11014125 FL Primary

Addresses

Primary practice location

1223 Gateway Dr Ste 2E
Melbourne, FL 32901-2607

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 361-5564

Other identifiers 2

IdentifierTypeStateIssuer
111806900MedicaidFL
OC952OtherFLMEDICARE HF

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210920000989 FL Practitioner - Nurse Practitioner 1254738123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians

Practice addresses (Care Compare)

1223 Gateway Dr
Melbourne, FL 32901-2607
Phone (321) 725-4500

Hospital & facility affiliations

  • Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Medical Group, LLC CurrentSince Nov 5, 2021 Accepting new patients
Health First Medical Group, LLC CurrentSince Nov 5, 2021 Accepting new patients

Locations

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

1223 Gateway Dr
Melbourne, FL 32901
Phone (321) 549-0677

1223 Gateway Dr
Ste 2E
Melbourne, FL 32901
Phone (321) 361-5564

1223 Gateway Dr
#2E
Melbourne, FL 32901
Phone (321) 361-5564

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

Interoperability endpoints

  • Direct secure messaging: tdavidson29280@epicdirect.hf.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1013683671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-361-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 GATEWAY DR STE 2E",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012607",
            "telephone_number": "321-361-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "TIFFANI",
        "credential": "APRN, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11014125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111806900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HF",
            "identifier": "OC952",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.