Tiffany Broughton

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

License

1001459 Issued in MS

Practice address

4918 Belfair CT
Moss Point, MS 39563-6212

Phone

(228) 235-0852

NPI assigned

Apr 18, 2024

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Ms. Tiffany Broughton Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 18, 2024.

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1992550487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4918 BELFAIR CT",
            "city": "MOSS POINT",
            "state": "MS",
            "postal_code": "395636212",
            "telephone_number": "228-235-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4918 BELFAIR CT",
            "city": "MOSS POINT",
            "state": "MS",
            "postal_code": "395636212",
            "telephone_number": "228-235-0852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGHTON",
        "first_name": "TIFFANY",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "MS",
            "license": "1001459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "BROUGHTON",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Moss Point, MS
• Phlebotomy Technician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.