Petra Tibshraeny, DOM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AP4119 Issued in FL

Practice address

7241 Bryan Dairy Rd Ste B
Largo, FL 33777-1538

Phone

(727) 420-7600

NPI assigned

May 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1124642830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7262 MOFFATT LN N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337814827",
            "telephone_number": "727-420-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7241 BRYAN DAIRY RD STE B",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337771538",
            "telephone_number": "727-420-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBSHRAENY",
        "first_name": "PETRA",
        "name_prefix": "Dr.",
        "credential": "DOM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP4119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen A Thompson, DC
• Alyssa Thurber, NP
• Albert H Thurlow III, ARNP
• Haihe Tian, A.P, PH.D.
• Madisyn Tibbetts
• Tickled Pink Medical, Inc.
• Tierra Pines Center, LLC
• Tiger Medical, Inc.
• Lenox Ashton Tillman, BCBA
• Richard F. Timmons, M.D.

• Acupuncturist in Largo, FL
• Providers in Largo, FL by specialty
• Acupuncturist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.

Verify at the official NPI Registry.