Individual provider Active NPI

Tiffany Mossman, ARNP

  • Critical Care Pediatric Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1124564190
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
9386281 Issued in FL
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

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
9386281FLMDCritical Care Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Orthopedics of Southwest FL Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.