Individual provider Active NPI

Ana Alicia Gomez Nova, NP-C

  • Family Nurse Practitioner
  • Tifton, GA
National Provider Identifier
1003371790
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN236233 Issued in GA
Practice address
1909 US Highway 82 W Ste 3&4
Tifton, GA 31793-8200
Phone
(229) 445-3509
NPI assigned
Feb 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN236233 GA
Family Nurse Practitioner 363LF0000X RN236233 GA Primary

Addresses

Primary practice location

1909 US Highway 82 W Ste 3&4
Tifton, GA 31793-8200

Mailing address

1909 US Highway 82 W Ste 3&4
Tifton, GA 31793-8200
Phone (229) 445-3509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190916000415 GA Practitioner - Nurse Practitioner 4183953235 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN236233GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnect Health, Inc. CurrentSince Aug 5, 2019 Accepting new patients
Careconnect Health, Inc. CurrentSince Aug 5, 2019 Accepting new patients
Fort Oglethorpe Emergency Physicians Group LLC CurrentSince Dec 1, 2024 Accepting new patients
Suwanee Pediatrics PC Past Accepting new patients

Locations

2855 Old Highway 5
Blue Ridge, GA 30513
Phone (706) 632-4263

510 Alston St
Ste B
Richland, GA 31825
Phone (229) 887-3324

901 18th St E
Tifton, GA 31794
Phone (229) 353-6208

1909 US Highway 82 W
Ste 34
Tifton, GA 31793
Phone (229) 445-3509

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1003371790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 US HIGHWAY 82 W STE 3&4",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317938200",
            "telephone_number": "229-445-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 US HIGHWAY 82 W STE 3&4",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317938200",
            "telephone_number": "229-445-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ NOVA",
        "first_name": "ANA",
        "middle_name": "ALICIA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN236233",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN236233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.