Tiffany Melissa Gaddis

Primary specialty

PharmacistTaxonomy code 183500000X

License

016616 Issued in KY

Practice address

1589 Highway 15 S
Jackson, KY 41339-9634

Phone

(606) 666-2622

Fax

(606) 666-7894

NPI assigned

Jun 19, 2014

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Wal-Mart Stores East LP

  • Community/Retail Pharmacy
  • Jackson, KY
  • NPI 1972521441
  NPD (past)
• Wal-Mart Stores East, LP

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1194139998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 HIGHWAY 15 S",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413399634",
            "telephone_number": "606-666-2622",
            "fax_number": "606-666-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1589 HIGHWAY 15 S",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413399634",
            "telephone_number": "606-666-2622",
            "fax_number": "606-666-7894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDIS",
        "first_name": "TIFFANY",
        "middle_name": "MELISSA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "016616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flying Eye PLLC
• Rebecca Lynn Fryman
• Brittany Moore Fugate, D.O.
• Gaddis Chiropractic Center PLLC
• Randall Keith Gaddis, D.C.
• Subir Ghosh, M.D.
• Jody Robin Gillum
• Jill Elaine Beattie Green, OTR/L
• Ranita Greer
• Rodney Brian Griffith, D.M.D.

• All providers in Jackson, KY
• Pharmacist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.