Tiffany Moore Brassard, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L003702 Issued in NC

Practice address

1050 Jabarrah Ave
Seymour Johnson a F B, NC 27531-2310

Phone

(919) 722-1822

Fax

(919) 722-1952

NPI assigned

Oct 6, 2011

Last updated

Oct 6, 2011By the provider in NPPES

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

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1285918342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 JABARRAH AVE",
            "city": "SEYMOUR JOHNSON A F B",
            "state": "NC",
            "postal_code": "275312310",
            "telephone_number": "919-722-1822",
            "fax_number": "919-722-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 JABARRAH AVE",
            "city": "SEYMOUR JOHNSON A F B",
            "state": "NC",
            "postal_code": "275312310",
            "telephone_number": "919-722-1822",
            "fax_number": "919-722-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASSARD",
        "first_name": "TIFFANY",
        "middle_name": "MOORE",
        "name_prefix": "Miss",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L003702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaiah Gary Allison
• Ryan Ashworth, MS, ATC, PMP
• Anthony Shawn Bankes, M.D.
• Cameron Thomas Beckham, PA-C
• Chelsea Berghorn, MS, LAT, ATC, CSCS
• Stacey Marie Brundrett, CNS
• Angela Marie Carter, IDMT
• Rachel Elizabeth Copeland, PHARMD
• Sheila Jo Davis, RN
• Kelby Joseph Sage Durnin, IDMT

• Registered Dietitian in Seymour Johnson AFB, NC
• Providers in Seymour Johnson AFB, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.

Verify at the official NPI Registry.