TIFFANY L. DODGE (NPI# 1417321969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417321969 |
| Entity Type | Individual |
| Full Name | TIFFANY L. DODGE |
| Other Name | TIFFANY L. DEFIORE |
| Credential | PA-C |
| Practice Address |
5500 Little Rd New Port Richey FL 34655-1105 |
| Mailing Address |
14690 Spring Hill Dr Ste 305 Spring Hill FL 34609-8102 |
| Practice Telephone | 7273721005 |
| Practice Fax Number | 7278077081 |
| Mailing Telephone | 3522775348 |
| Mailing Fax Number | 3526062857 |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2020-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9109263 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 016655400 | 05 | |
| FL | BLUE CROSS BLUE SHIELD | HUYKT | 01 |
| Street Address |
5500 LITTLE RD |
| City | NEW PORT RICHEY |
| State | FL |
| Zip Code | 34655-1105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023324035 | David Herndon | Family Medicine | 5500 Little Rd, New Port Richey, FL 34655 | 2010-08-27 |
| 1831747914 | Farah Lakhani | Nurse Practitioner | 5500 Little Rd, New Port Richey, FL 34655-1105 | 2019-08-31 |
| 1750815544 | Irina Maria Popa | Nurse Practitioner | 5500 Little Rd, New Port Richey, FL 34655-1105 | 2017-04-18 |
| 1598112450 | Monica April Esposito | Family Medicine | 5500 Little Rd, New Port Richey, FL 34655-1105 | 2016-05-20 |
| 1245611128 | Amber Duren | Nurse Practitioner | 5500 Little Rd, New Port Richey, FL 34655 | 2015-06-16 |
| 1437402294 | Yana Geyvandova | Nurse Practitioner | 5500 Little Rd, New Port Richey, FL 34655-1105 | 2012-10-17 |
| 1366719213 | Florida Cancer Affiliates Pl | Radiology | 5500 Little Rd, New Port Richey, FL 34655-1105 | 2011-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245845221 | Kathryn E Wright | Social Worker | 8225 Florida State Road 54, New Port Richey, FL 34655 | 2020-09-15 |
| 1245873728 | Trinity Counseling Services | Marriage & Family Therapist | 1934 Duck Slough, Trinity, FL 34655 | 2019-10-28 |
| 1134770563 | Timothy Foster | Licensed Practical Nurse | 9332 Sr 54, Ste 202, Trinity, FL 34655 | 2019-09-26 |
| 1710542824 | Leah E. Grossman | Student in an Organized Health Care Education/Training Program | Medical Center of Trinity, 9330 State Rd 54, Trinity, FL 34655 | 2019-05-03 |
| 1508420696 | Varun Reddy | Student in an Organized Health Care Education/Training Program | 9330 Fl 54, Trinity, FL 34655 | 2019-04-24 |
| 1184183642 | Courtney Lynne Fagan | Specialist/Technologist | 8225 Fl-54, New Port Richey, FL 34655 | 2019-03-14 |
| 1164996633 | Brooke E Cox | Obstetrics & Gynecology | 8145 Cerebellum Way Ste 102, Trinity, FL 34655 | 2019-01-17 |
| 1144734591 | Optimal Performance and Physical Therapies Trinity LLC | Physical Therapist | 11157 Trinity Blvd, Trinity, FL 34655 | 2017-11-21 |
| 1629581285 | Nationwide Vision Center, LLC | Technician/Technologist | 3238 Little Rd, Trinity, FL 34655 | 2017-11-06 |
| 1053834267 | Spnn LLC | Pharmacy | 5429 Little Rd, New Port Richey, FL 34655 | 2017-07-19 |
| Find all providers in zip 34655 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992279996 | Colleen O'kennedy Seletos | Physician Assistant | 2843 Shipston Ave, New Port Richey, FL 34655-3722 | 2019-01-14 |
| 1598088460 | Kimberly Lockwood Flynn | Physician Assistant | 5809 Sunshine Park Dr, New Port Richey, FL 34652-5540 | 2010-03-08 |
| 1437281185 | Danielle Maria Kinsey | Physician Assistant | 9330 Sr 54, New Port Richey, FL 34655 | 2007-03-09 |
| 1053386797 | Brian Michael M. Swann | Physician Assistant | 9912 Little Rd, Va-opc-npr / PCc3, New Port Richey, FL 34654-3419 | 2006-02-17 |
| 1134110307 | Maya N Benton | Physician Assistant | 4807 Us Highway 19 Ste 102, New Port Richey, FL 34652-4260 | 2005-11-04 |
| 1912998493 | Dwight E Hofer | Physician Assistant | 5243 Hanff Ln, New Port Richey, FL 34652-4226 | 2005-11-02 |
| 1225500861 | Brittany Lynn Nooney | Physician Assistant | 6600 Madison St, New Port Richey, FL 34652-1971 | 2018-12-20 |
| 1033587092 | Julie Marchenia | Physician Assistant | 5622 Marine Pkwy, Suite 14, New Port Richey, FL 34652-4333 | 2015-09-08 |
| 1710366406 | Sharon Garry | Physician Assistant | 6633 Forest Ave, Suite 203, New Port Richey, FL 34653-2612 | 2015-05-27 |
| 1427440544 | Stephanie Bonventre | Physician Assistant | 6600 Madison St, New Port Richey, FL 34652-1971 | 2015-02-26 |
| Find all providers in NEW PORT RICHEY | ||||
| City | NEW PORT RICHEY |
| Zip Code | 34655 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.