TIFFANY FAYE BRADDY, APRN — NPI 1760165013 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care in MACCLENNY, FL)

CMS-1500 Box 24J / 33a • NPI

1760165013

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

363LP2300X (CMS 50)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care

Box 32 Service Location & ZIP+4

159 N 3RD ST, MACCLENNY, FL, 32063-2103

✓ 9-Digit EDI 837 ZIP+4 (32063-2103)

Practice Phone & Referral Fax

(904) 259-3151

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1760165013 (TIFFANY FAYE BRADDY, APRN) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1760165013` (NPI-1 Individual Practitioner)
Provider / Legal Name	TIFFANY FAYE BRADDY, APRN
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care NUCC Code: `363LP2300X` (Nurse Practitioner, Primary Care)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	159 N 3RD ST, MACCLENNY, FL, 32063-2103
Practice Telephone / Fax	Tel: (904) 259-3151
Administrative Mailing Address	159 N 3RD ST, MACCLENNY, FL, 32063-2103
Enumeration & Last Sync	Enumerated: 2023-08-11 \| CMS Record Updated: 2023-08-11

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

159 N 3RD ST, MACCLENNY, FL, 32063-2103

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Plain-English Taxonomy & CMS Crosswalk (363LP2300X)

What Does Taxonomy Code 363LP2300X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LP2300X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 50 (Nurse Practitioner)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Practitioner, Primary Care for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (TIFFANY FAYE BRADDY, APRN)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`363LP2300X` — Nurse Practitioner, Primary Care Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care	State: FL \| License: `11028047` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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TIFFANY FAYE BRADDY, APRN (NPI #1760165013)