Individual provider Active NPI

Tiffany Daniel, PHARM D

  • Pharmacist
  • Pine Bluff, AR
National Provider Identifier
1043857394
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PD10797 Issued in AR
Practice address
1605 E Harding Ave
Pine Bluff, AR 71601-6823
Phone
(870) 534-1380
Fax
(866) 572-0139
NPI assigned
Dec 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD10797 AR Primary

Addresses

Primary practice location

1605 E Harding Ave
Pine Bluff, AR 71601-6823

Mailing address

1605 E Harding Ave
Pine Bluff, AR 71601-6823
Phone (870) 534-1380

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PD10797ARMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Brookshire Grocery Company PastSince Dec 9, 2019 Accepting new patients
Brookshire Grocery Company PastSince Dec 9, 2019 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1043857394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 E HARDING AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716016823",
            "telephone_number": "870-534-1380",
            "fax_number": "866-572-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 E HARDING AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716016823",
            "telephone_number": "870-534-1380",
            "fax_number": "866-572-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "TIFFANY",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-05",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD10797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.