Individual provider Active NPI

Tiffany Todd, ARNP

  • Family Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1992100788
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9182505 Issued in FL
Practice address
620 10TH St N
St Petersburg, FL 33705-1407
Phone
(727) 824-3120
Fax
(727) 824-8313
NPI assigned
Oct 23, 2014
Last updated
Nov 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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 ARNP9182505 FL Primary

Addresses

Primary practice location

620 10TH St N
St Petersburg, FL 33705-1407

Mailing address

PO Box 12868
St Petersburg, FL 33733-2868
Phone (727) 532-0002

Other identifiers 1

IdentifierTypeStateIssuer
014436900MedicaidFL

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
I20150316000054 FL Practitioner - Nurse Practitioner 9133446925 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9182505FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Management of Florida Inc CurrentSince Mar 1, 2018 Accepting new patients
Pophealthcare, LLC PastSince Mar 8, 2016 Accepting new patients

Locations

2191 9th Ave N
Ste 110
St Petersburg, FL 33713
Phone (727) 322-1600

2155 SE Federal Hwy
Stuart, FL 34994
Phone (772) 223-9630

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

NPI Registry JSON

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1992100788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12868",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337332868",
            "telephone_number": "727-532-0002",
            "fax_number": "727-266-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 10TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051407",
            "telephone_number": "727-824-3120",
            "fax_number": "727-824-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "TIFFANY",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9182505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014436900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.