Individual provider Active NPI

Tiffany Logan

  • Certified Registered Nurse Anesthetist
  • Tampa, FL
National Provider Identifier
1508565219
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN9448351 Issued in FL
Practice address
12901 Bruce B Downs Blvd
Tampa, FL 33612-4742
Phone
(813) 974-2191
NPI assigned
Mar 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2026018269 MO
Certified Registered Nurse Anesthetist 367500000X RN9448351 FL Primary

Addresses

Primary practice location

12901 Bruce B Downs Blvd
Tampa, FL 33612-4742

Mailing address

12901 Bruce B Downs Blvd
Tampa, FL 33612-4742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, WA, MO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230922002142 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698129781 Reassigns benefits to 1 organization
I20260211001920 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698129781 Reassigns benefits to 2 organizations
I20260518001210 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698129781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of South Florida College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Ozark Anesthesia and Associates, IncGroup PAC ID 6305806530, 22 clinicians

Practice addresses (Care Compare)

54 Hospital Dr
Osage Beach, MO 65065-3050
Phone (573) 348-8000

Hospital & facility affiliations

  • Lake Regional Health System Hospital, Osage Beach, MO, CCN 260186

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9448351FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Prosser Public Hospital District of Benton County CurrentSince Aug 1, 2025 Accepting new patients
Prosser Public Hospital District of Benton County CurrentSince Dec 10, 2025 Accepting new patients
Prosser Public Hospital District of Benton County CurrentSince Aug 1, 2025 Accepting new patients
Capital Anesthesia Solutions of Arkansas, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 5, 2023 Accepting new patients

Locations

3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

1105 Dale Ave
Benton City, WA 99320
Phone (509) 588-4075

200 Prosser Health Dr
Prosser, WA 99350
Phone (509) 786-2222

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1508565219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742",
            "telephone_number": "813-974-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-01",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2026018269",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "RN9448351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.