Individual provider Active NPI

Tiffany Entrekin McMillan, CRNP

  • Neonatal Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1568803930
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
11024858 Issued in FL
Practice address
2010 Brookwood Medical Ctr Dr
Birmingham, AL 35209-6804
Phone
(205) 547-4848
NPI assigned
Jul 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X 1-126132 AL
Neonatal Nurse Practitioner 363LN0000X 11024858 FL Primary

Addresses

Primary practice location

2010 Brookwood Medical Ctr Dr
Birmingham, AL 35209-6804

Mailing address

2208 Jacobs Rd
Vestavia, AL 35216-2525
Phone (205) 919-1703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20251028000727 FL Practitioner - Nurse Practitioner 0648769919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10140 Centurion Pkwy N
Jacksonville, FL 32256-0532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11024858FLMDNeonatal Nurse Practitioner
1-126132ALMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Aug 9, 2025 Accepting new patients
The Nemours Foundation CurrentSince Aug 9, 2025 Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

8331 N Davis Hwy
Spc Care
Pensacola, FL 32514
Phone (850) 505-4700

8331 N Davis Hwy
Pensacola, FL 32514
Phone (850) 505-4700

Organizations & group practices 3

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": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1568803930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 JACOBS RD",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352162525",
            "telephone_number": "205-919-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 BROOKWOOD MEDICAL CTR DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096804",
            "telephone_number": "205-547-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "TIFFANY",
        "middle_name": "ENTREKIN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-12",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "AL",
            "license": "1-126132",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "FL",
            "license": "11024858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.