Active NPI
Maranda S Tiffany, MPT
- Physical Therapist
- Ormond Beach, FL
National Provider Identifier
1275725319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT22240
- Practice address
- 26 N Beach St
Suite B
Ormond Beach, FL 32174-5663 - Phone
- (386) 673-0201
- Fax
- (386) 677-8143
- NPI assigned
- Aug 13, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT22240 | FL | Primary |
Addresses
Primary practice location
26 N Beach St
Suite B
Ormond Beach, FL 32174-5663
Mailing address
2 Woodford LN
Palm Coast, FL 32164-7927
Phone (386) 597-5869
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y04EA | Other | FL | BCBS NON-PAR |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295481600000",
"number": "1275725319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 WOODFORD LN",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321647927",
"telephone_number": "386-597-5869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 N BEACH ST",
"address_2": "SUITE B",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321745663",
"telephone_number": "386-673-0201",
"fax_number": "386-677-8143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIFFANY",
"first_name": "MARANDA",
"middle_name": "S",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-13",
"last_updated": "2011-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT22240",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NON-PAR",
"identifier": "Y04EA",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.