NPIMap

Individual provider Active NPI

Tiffany McClain

  • Family Nurse Practitioner
  • Orange Park, FL
National Provider Identifier
1740658954
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9328541 Issued in FL
Practice address
1075 Oakleaf Plantation Pkwy
Ste 108
Orange Park, FL 32065-3624
Phone
(904) 282-4565
NPI assigned
Sep 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9328541 FL Primary

Addresses

Primary practice location

1075 Oakleaf Plantation Pkwy
Ste 108
Orange Park, FL 32065-3624

Mailing address

575 Timber Trace CT
Orange Park, FL 32073-1610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151201002081 FL Practitioner - Nurse Practitioner 4486954211 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
Telehealth
Offers telehealth services
Group practices
My Choice Operating Company LLCGroup PAC ID 3779991542, 60 clinicians

Practice addresses (Care Compare)

4655 Salisbury Rd
Suite 220
Jacksonville, FL 32256-0959
Phone (904) 570-9404

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9328541FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
My Choice Operating Company LLC CurrentSince Apr 19, 2021 Accepting new patients

Locations

4655 Salisbury Rd
Ste 220
Jacksonville, FL 32256
Phone (904) 570-9404

4319 Salisbury Rd
Ste 103
Jacksonville, FL 32216
Phone (904) 570-9404

4655 Salisbury Rd
Ste 110
Jacksonville, FL 32256
Phone (904) 570-9404

Organizations & group practices 1

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.

Hospital & facility affiliations 11

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": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1740658954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 TIMBER TRACE CT",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320731610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 OAKLEAF PLANTATION PKWY",
            "address_2": "STE 108",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320653624",
            "telephone_number": "904-282-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLAIN",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9328541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.