Tiffany Brenda Joy Roberts

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

ARNP9398714 Issued in FL

Practice address

2905 Highway 77
Panama City, FL 32405-5013

Phone

(850) 257-5527

Fax

(850) 258-3902

NPI assigned

Oct 5, 2015

Last updated

Aug 9, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Tiffany Hollenbeck Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment NPD
• FL-I Medical Services, LLC

  • Nurse Practitioner
  • Fort Pierce, FL
  • NPI 1750655106
  Medicare reassignment NPD
• FL-I Medical Services LLC

  • Physician Assistant
  • Haines City, FL
  • NPI 1285356790
  NPD
• FL-I Medical Services LLC

  • Emergency Medicine Physician
  • Destin, FL
  • NPI 1659720654
  NPD
• Rainbow Pediatrics PC LLC

  • Pediatrics Physician
  • Panama City, FL
  • NPI 1134569049
  NPD (past)

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1629448543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 HIGHWAY 77",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324055013",
            "telephone_number": "850-257-5527",
            "fax_number": "850-258-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 HIGHWAY 77",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324055013",
            "telephone_number": "850-257-5527",
            "fax_number": "850-258-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TIFFANY",
        "middle_name": "BRENDA JOY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9398714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "HOLLENBECK",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert M Copp DC PA
• Doris M Roberts, CNP
• Jennifer Dawn Roberts, APRN
• Kayla Elizabeth Roberts, NP
• Sheldon J Roberts, PA
• Deborah B Robertson
• Nadine Robertson, MD
• Jennifer G Robinette, ARNP-C
• Robinson Alf BSLC LLC (Robinson Residential Care)
• Tammy Robinson-Chambers, LMHC, CAP

• Pediatric Nurse Practitioner in Panama City, FL
• Providers in Panama City, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.