Active NPI
Tiffany Moye
- Pharmacist
- Crestview, FL
National Provider Identifier
1073119509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS33735
- Practice address
- 302 E James Lee Blvd
Crestview, FL 32539-2827 - Phone
- (850) 682-1002
- NPI assigned
- Dec 9, 2020
- Last updated
- Dec 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS33735 | FL | Primary |
Addresses
Primary practice location
302 E James Lee Blvd
Crestview, FL 32539-2827
Mailing address
302 E James Lee Blvd
Crestview, FL 32539-2827
Phone (850) 682-1002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS33735 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Cvs | Health Information Exchange (HIE) |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS33735 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607472000000",
"number": "1073119509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 E JAMES LEE BLVD",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325392827",
"telephone_number": "850-682-1002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 E JAMES LEE BLVD",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325392827",
"telephone_number": "850-682-1002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOYE",
"first_name": "TIFFANY",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-09",
"last_updated": "2020-12-09",
"certification_date": "2020-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS33735",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PS33735",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Cvs",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "302 E James Lee Blvd",
"city": "Crestview",
"state": "FL",
"country_code": "US",
"postal_code": "325392827",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Crestview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.