Tiffany Faye Braddy, APRN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

11028047 Issued in FL

Practice address

159 N 3Rd St
Macclenny, FL 32063-2103

Phone

(904) 259-3151

NPI assigned

Aug 11, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baker Community Health Center IncGroup PAC ID 3779689807, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hometown Home Health LLC Home health agency, Macclenny, FL, CCN 687054
• Ed Fraser Memorial Hospital Hospital, Macclenny, FL, CCN 100134

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 and National Provider Directory roles.

• Baker Community Health Center Inc

  • Emergency Medicine Physician
  • Macclenny, FL
  • NPI 1396807319

  FL

  Medicare reassignment Care Compare group NPD
• Baker County Medical Services Inc

  • Rural Acute Care Hospital
  • Macclenny, FL
  • NPI 1104926401

  FL

  Medicare reassignment NPD
• Baker County Medical Services Inc

  • Rural Health Clinic/Center
  • Macclenny, FL
  • NPI 1386082220
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baker County Medical Services Inc

  • Rural Acute Care Hospital
  • Macclenny, FL
  • NPI 1104926401

  Hospital

  Care Compare affiliation
• Hometown Home Health LLC

  • Home Health Agency
  • Macclenny, FL
  • NPI 1912549114
  Care Compare affiliation

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

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1760165013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 N 3RD ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632103",
            "telephone_number": "904-259-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 N 3RD ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632103",
            "telephone_number": "904-259-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADDY",
        "first_name": "TIFFANY",
        "middle_name": "FAYE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-11",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11028047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexcia Bennett
• Benso Gold Dental, P.a.
• Bio-Medical Applications of Florida, Inc.
• Amanda Jean Bondie
• Janie Boulware
• Johnnie N Bradley-Goodman, APRN, PMHNP - BC
• Brittany N Day, DDS, PA
• Angela Broadnax
• Jennifer K Brown, ARNP
• Robert Brown, PHARMD

• All providers in Macclenny, FL
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.