Tiffany Douglas

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11034085 Issued in FL

Practice address

75 Varick St FL 5
New York, NY 10013-1917

Phone

(855) 961-1942

Fax

(866) 702-0882

NPI assigned

Oct 9, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: tiffany.douglas.1@14883.direct.athenahealth.com

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770422400000",
    "number": "1588035018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 VARICK ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100131917",
            "telephone_number": "855-961-1942",
            "fax_number": "866-702-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 VARICK ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100131917",
            "telephone_number": "855-961-1942",
            "fax_number": "866-702-0882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4030 Wake Forest Rd Ste 349",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276090010",
            "country_code": "US",
            "telephone_number": "864-620-1741",
            "fax_number": "864-448-1754",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Soldiers Field Park",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021631722",
            "country_code": "US",
            "telephone_number": "864-423-3561",
            "fax_number": "864-448-1754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2026-02-07",
        "certification_date": "2026-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5012697",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN270965",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "26784",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11034085",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2299504",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter A Douglas, MSW
• Rebecca Christina Douglas, FNP
• Samuel Garrison Douglas, LCSW
• Samuel Reed Douglas, LCSW
• Teshanee Dara Douglas, LPN
• Zachary Douglas
• Alexandra Frances Douglass, LMSW
• Claire L Douglass, PA-C
• Elijah Douglass, M.D.
• Ashley Marguerite Doukas, PHD

• Family Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2026; 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.