Tiffany Douglas

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA5278 Issued in SC

Practice address

4 Carriage LN Ste 200
Charleston, SC 29407-6049

Phone

(843) 266-7573

NPI assigned

Oct 1, 2021

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

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Myndspace Mental Health Education & Consulting, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Charleston, SC
  • NPI 1215541669
  Medicare reassignment

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771113600000",
    "number": "1346912946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CARRIAGE LN STE 200",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076049",
            "telephone_number": "843-266-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CARRIAGE LN STE 200",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076049",
            "telephone_number": "843-266-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2026-02-15",
        "certification_date": "2026-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "PA5278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noah Landon Doughty
• Shannon S Doughty, PHD, BCBA
• Douglas J. Alterman, D.M.D., P.a.
• Barbara L Douglas, RPH
• Jennifer Desiree Douglas, PA
• Dove Meadow Therapy Co, LLC
• James Junius Dove, PAC
• Rory Dowd, MBBS, MENG
• Timothy Michael Dowd, DDS
• Merriman Dowdle, PA

• Physician Assistant in Charleston, SC
• Providers in Charleston, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.