Individual provider Active NPI

Tiffany Renae Prewitt, NP

  • Nurse Practitioner
  • Enterprise, AL
National Provider Identifier
1619469426
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-130362 Issued in AL
Practice address
400 N Edwards St
Enterprise, AL 36330-2584
Phone
(334) 347-0584
NPI assigned
Jun 6, 2018
Last updated
Apr 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11026588 FL
Nurse Practitioner 363L00000X 1-130362 AL Primary

Addresses

Primary practice location

400 N Edwards St
Enterprise, AL 36330-2584

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181010000032 AL Practitioner - Nurse Practitioner 4981956588 Reassigns benefits to 4 organizations
I20240510003314 FL Practitioner - Nurse Practitioner 4981956588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians
Flowers HB Medical Services LLCGroup PAC ID 6305290990, 139 clinicians

Practice addresses (Care Compare)

13139 Sorrento Rd
Pensacola, FL 32507-8777
Phone (850) 746-0020

4370 W Main St
Dothan, AL 36305-1056
Phone (334) 793-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
45.86 of 100Reported as group
Quality
6.09
Improvement activities
40
Cost
81.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-130362ALMDNurse Practitioner
11026588FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince May 15, 2025 Accepting new patients
Cep America, LLC Current Accepting new patients
Southern Alabama Physicians LLP CurrentSince May 22, 2018 Accepting new patients
Southern Alabama Physicians,LLP CurrentSince May 22, 2018 Accepting new patients
App of Alabama Ed PLLC CurrentSince Nov 3, 2021 Accepting new patients
Northern Alabama Physicians, LLP Current Accepting new patients
Cep America LLC CurrentSince May 15, 2025 Accepting new patients
Northern Alabama Physicians, LLP CurrentSince Jun 15, 2020 Accepting new patients
Flowers HB Medical Services LLC Nurse Practitioner CurrentSince Oct 8, 2023 Accepting new patients

Locations

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

400 N Edwards St
Enterprise, AL 36330
Phone (334) 347-0584

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

13139 Sorrento Rd
Pensacola, FL 32507
Phone (850) 492-0543

200 Corporate Blvd
Lafayette, LA 70508

Organizations & group practices 9

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.

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": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1619469426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N EDWARDS ST",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302584",
            "telephone_number": "334-347-0584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREWITT",
        "first_name": "TIFFANY",
        "middle_name": "RENAE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11026588",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-130362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.