Active NPI
Tiki Stafford
- Lodging Provider
- Jacksonville, FL
National Provider Identifier
1427234152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lodging Provider
- License
- AL11189
- Practice address
- 523 Fern St
Jacksonville, FL 32206-6238 - Phone
- (904) 764-2891
- NPI assigned
- Jan 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Lodging Provider | 177F00000X | AL11189 | FL | Primary |
Addresses
Primary practice location
523 Fern St
Jacksonville, FL 32206-6238
Mailing address
523 Fern St
Jacksonville, FL 32206-6238
Phone (904) 764-2891
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AL11189 | Other | FL | AHCA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL11189 | FL | MD | Lodging Provider |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reffines House | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200009600000",
"number": "1427234152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 FERN ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322066238",
"telephone_number": "904-764-2891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "523 FERN ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322066238",
"telephone_number": "904-764-2891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAFFORD",
"first_name": "TIKI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-11",
"last_updated": "2008-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "177F00000X",
"taxonomy_group": "",
"desc": "Lodging",
"state": "FL",
"license": "AL11189",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCA",
"identifier": "AL11189",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.