Individual provider Active NPI

Tiffanie Diane Radney, ARNP-C

  • Family Nurse Practitioner
  • Haines City, FL
National Provider Identifier
1821405911
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9235190 Issued in FL
Practice address
295 Patterson Rd
Haines City, FL 33844-6247
Phone
(863) 422-4338
Fax
(863) 422-3736
NPI assigned
Jul 21, 2014
Last updated
Nov 4, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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 ARNP9235190 FL Primary

Addresses

Primary practice location

295 Patterson Rd
Haines City, FL 33844-6247

Mailing address

295 Patterson Rd
Haines City, FL 33844-6247
Phone (863) 422-4338

Other identifiers 1

IdentifierTypeStateIssuer
013020400MedicaidFL

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
I20140924002169 FL Practitioner - Nurse Practitioner 5799904785 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Florida College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians
Central Florida Kidney Specialists IncGroup PAC ID 6608233705, 38 clinicians

Practice addresses (Care Compare)

200 Ave F NE
Winter Haven, FL 33881-4131
Phone (863) 293-1121

3885 Oakwater Cir
Orlando, FL 32806-6257
Phone (407) 816-5700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Contracting Services LLC CurrentSince Jul 16, 2018 Accepting new patients
Central Florida Kidney Specialists Inc CurrentSince Jun 1, 2023 Accepting new patients
Paragon Emergency Services LLC CurrentSince Oct 1, 2015 Accepting new patients
Renal Access of Central Florida LLC Past Accepting new patients

Locations

130 Ridge Center Dr
Ste 203
Davenport, FL 33837
Phone (863) 422-4338

33048 US Hwy 27 N
Haines City, FL 33844
Phone (787) 248-9885

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

3885 Oakwater Cir
Orlando, FL 32806
Phone (407) 816-5700

200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1821405911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 PATTERSON RD",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338446247",
            "telephone_number": "863-422-4338",
            "fax_number": "863-422-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 PATTERSON RD",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338446247",
            "telephone_number": "863-422-4338",
            "fax_number": "863-422-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADNEY",
        "first_name": "TIFFANIE",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9235190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013020400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haines City, FL

Sources for this page

Verify at the official NPI Registry.