Individual provider Active NPI

Tiffany Anne Stafford, PHARMD

  • Pharmacist
  • Aldie, VA
National Provider Identifier
1508262080
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202213034 Issued in VA
Practice address
42025 Village Center PLZ
Aldie, VA 20105-3027
Phone
(703) 722-2829
NPI assigned
Nov 12, 2014
Last updated
Nov 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202213034 VA Primary

Addresses

Primary practice location

42025 Village Center PLZ
Aldie, VA 20105-3027

Mailing address

42025 Village Center PLZ
Aldie, VA 20105-3027

Other identifiers 1

IdentifierTypeStateIssuer
0202213034OtherVAPHARMACIST

Other names 1

  • Tiffany Anne Johnson Former name

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0202213034VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co. PastSince Mar 6, 2022 Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1508262080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42025 VILLAGE CENTER PLZ",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201053027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42025 VILLAGE CENTER PLZ",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201053027",
            "telephone_number": "703-722-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "TIFFANY",
        "middle_name": "ANNE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-12",
        "last_updated": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202213034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "0202213034",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "JOHNSON",
            "middle_name": "ANNE",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aldie, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.