Active NPI
Tiffany Mossman, ARNP
- Critical Care Pediatric Nurse Practitioner
- Fort Myers, FL
National Provider Identifier
1124564190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pediatric Nurse Practitioner
- License
- 9386281
- Practice address
- 15821 Hollyfern CT
Fort Myers, FL 33908-3732 - Phone
- (239) 432-5100
- NPI assigned
- Jan 13, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Registered Nurse | 163WX0800X | 9386281 | FL | |
| Critical Care Pediatric Nurse Practitioner | 363LP0222X | 9386281 | FL | Primary |
Addresses
Primary practice location
15821 Hollyfern CT
Fort Myers, FL 33908-3732
Mailing address
21586 Belvedere LN
Estero, FL 33928-7329
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 |
|---|---|---|---|
| 9386281 | FL | MD | Critical Care Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Orthopedics of Southwest FL | Past | Accepting new patients |
Interoperability endpoints
- tmossman100102@direct.leememorial.org
Organizations & group practices 1
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.
-
- Pediatric Orthopaedic Surgery Physician
- Fort Myers, FL
- NPI 1386786838
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487635200000",
"number": "1124564190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21586 BELVEDERE LN",
"city": "ESTERO",
"state": "FL",
"postal_code": "339287329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15821 HOLLYFERN CT",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339083732",
"telephone_number": "239-432-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSSMAN",
"first_name": "TIFFANY",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-13",
"last_updated": "2017-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WX0800X",
"taxonomy_group": "",
"desc": "Registered Nurse, Orthopedic",
"state": "FL",
"license": "9386281",
"primary": false
},
{
"code": "363LP0222X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics, Critical Care",
"state": "FL",
"license": "9386281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.