Individual provider Active NPI

Tiffany Amanda Valverde Anderson, MD

  • Family Medicine Physician
  • Fleming Island, FL
National Provider Identifier
1831779057
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME166750 Issued in FL
Practice address
2310 Village Square Pkwy Ste 206
Fleming Island, FL 32003-6409
Phone
(904) 264-4405
Fax
(904) 391-5380
NPI assigned
Apr 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME166750 FL Primary

Addresses

Primary practice location

2310 Village Square Pkwy Ste 206
Fleming Island, FL 32003-6409

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-1032

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240617003989 FL Practitioner - Family Practice 8224571302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

2310 Village Square Pkwy
Suite 206
Fleming Island, FL 32003-6351
Phone (904) 264-4405

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME166750FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Baptist Primary Care Inc Family Medicine CurrentSince Aug 1, 2024 Accepting new patients

Locations

2310 Village Square Pkwy
Ste 206
Fleming Island, FL 32003
Phone (904) 264-4405

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

Interoperability endpoints

  • Direct secure messaging: tvalverdeanderson174614@baptisthealthsystemjacksonville.direct-ci.com

Organizations & group practices 2

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 5

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": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1831779057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 VILLAGE SQUARE PKWY STE 206",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320036409",
            "telephone_number": "904-264-4405",
            "fax_number": "904-391-5380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALVERDE ANDERSON",
        "first_name": "TIFFANY",
        "middle_name": "AMANDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME166750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

Verify at the official NPI Registry.