Individual provider Active NPI

Tiffany Nicole Charney, CPNP-AC/PC

  • Pediatric Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1679942890
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
11013729 Issued in FL
Practice address
4951 Grande Dr
Pensacola, FL 32504-8965
Phone
(850) 473-0100
Fax
(850) 473-0500
NPI assigned
Sep 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 113163 NE
Pediatric Nurse Practitioner 363LP0200X 5007990 NC
Pediatric Nurse Practitioner 363LP0200X 11013729 FL Primary
Pediatric Nurse Practitioner 363LP0200X 3-000676 AL

Addresses

Primary practice location

4951 Grande Dr
Pensacola, FL 32504-8965

Mailing address

4951 Grande Dr
Pensacola, FL 32504-8965
Phone (850) 473-0100

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
I20251224001968 FL Practitioner - Nurse Practitioner 6507117587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

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
11013729FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Nov 16, 2025 Accepting new patients
The Nemours Foundation CurrentSince Nov 16, 2025 Accepting new patients
Kids Care Pediatrics PA Nurse Practitioner Past Accepting new patients

Locations

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

164 NW Madison St
Spc Care
Lake City, FL 32055
Phone (386) 758-1811

83 Columbia St
Orlando, FL 32806
Phone (321) 843-3220

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

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

Interoperability endpoints

  • Direct secure messaging: tcharney144923@direct.nemours.org
  • Direct secure messaging: tiffanycharney@kidscarepe.allscriptsdirect.net

Organizations & group practices 4

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": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1679942890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048965",
            "telephone_number": "850-473-0100",
            "fax_number": "850-473-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048965",
            "telephone_number": "850-473-0100",
            "fax_number": "850-473-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARNEY",
        "first_name": "TIFFANY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "CPNP-AC/PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "113163",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5007990",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "11013729",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "3-000676",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.