TIFFANY FAYE BRADDY (APRN) – Primary Care Nurse Practitioner, NPI 1760165013

TIFFANY FAYE BRADDY (APRN) is a healthcare provider. based in Macclenny, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 11028047 (FL). The NPI Number for TIFFANY FAYE BRADDY (APRN) is 1760165013

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
TIFFANY FAYE BRADDY (APRN)
NPI
1760165013
Phone
(904) 259-3151
Address
159 N 3RD ST
Enumeration Date
11 August 2023
Last Update Date
11 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
90425931515103
Graduation Year
2023 (3 years ago)
PAC ID
6709240120
Group Practice PAC ID
3779689807
Professional Enrollment ID
I20230918002572
Address ID
FL320632103MA159XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for TIFFANY FAYE BRADDY (APRN)

  • 159 N 3RD ST

    MACCLENNY, FL 320632103

    Phone: (904) 259-3151

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $188.

Total Amount is formed as General ($188) + Research ($0) + Ownership ($0) = $188.

Last reported payment date: 2024-09-25 • Largest payer in this snapshot: Recor Medical Inc ($122).

Total Amount

$188

General + Research + Ownership

Payments

4

Total payment records

General Amount

$188

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-25

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-09-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230918002572INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32063)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3779689807View full group profile
NameSpecialtyState
Diagnostic RadiologyVA
-WV
Nurse PractitionerFL
Diagnostic RadiologyOR
Diagnostic RadiologyOR
Cardiovascular Disease (Cardiology)AR
Diagnostic RadiologyTX
Diagnostic RadiologyTX
-MN
Diagnostic Radiology, Internal MedicineWA

Reviews

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Frequently asked questions

What federal number belongs to TIFFANY FAYE BRADDY (APRN)?
The federal identifier for TIFFANY FAYE BRADDY (APRN) is NPI 1760165013.
Does this profile mean TIFFANY FAYE BRADDY (APRN) is currently active?
Yes — TIFFANY FAYE BRADDY (APRN) appears active in the national provider directory.
Does TIFFANY FAYE BRADDY (APRN) list a primary specialty?
If you are matching referrals, note Primary Care Nurse Practitioner for TIFFANY FAYE BRADDY (APRN). Clinical services aligned with this taxonomy classification.
What location shows for TIFFANY FAYE BRADDY (APRN)?
We surface Macclenny, Florida for TIFFANY FAYE BRADDY (APRN) based on available NPPES addresses.
What if Macclenny, Florida seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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