Individual provider Active NPI

Callie Haynes, FNP-BC

  • Family Nurse Practitioner
  • Tifton, GA
National Provider Identifier
1003527714
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP287090 Issued in GA
Practice address
1622 Madison Ave
Tifton, GA 31794-3756
Phone
(229) 387-8061
NPI assigned
Dec 13, 2022
Last updated
Oct 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP287090 GA Primary

Addresses

Primary practice location

1622 Madison Ave
Tifton, GA 31794-3756

Mailing address

532 Osprey Cir
Tifton, GA 31794-1672
Phone (229) 326-2996

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
I20230322000417 GA Practitioner - Nurse Practitioner 9335513902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tift Regional Health System IncGroup PAC ID 2062745169, 294 clinicians

Practice addresses (Care Compare)

1493 Kennedy Rd
Suite a
Tifton, GA 31794-4178
Phone (229) 391-4130

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NP287090GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tift Regional Health System Inc CurrentSince Sep 1, 2024 Accepting new patients
Orthopedic Surgeons of Georgia, LLC CurrentSince Dec 13, 2022 Accepting new patients
Tift Regional Health System Inc CurrentSince Sep 1, 2024 Accepting new patients
Orthopedic Surgeons of Georgia LLC CurrentSince Dec 13, 2022 Accepting new patients
Tift Regional Health System Inc Current Accepting new patients

Locations

100 Doctors Dr
Ste F
Douglas, GA 31533
Phone (912) 383-4945

11 Cross St
Hazlehurst, GA 31539
Phone (912) 375-2884

1493 Kennedy Rd
Ste A
Tifton, GA 31794
Phone (229) 391-4130

1622 Madison Ave
Tifton, GA 31794
Phone (229) 387-8061

2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188

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

Organizations & group practices 5

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1003527714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 OSPREY CIR",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941672",
            "telephone_number": "229-326-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 MADISON AVE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943756",
            "telephone_number": "229-387-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "CALLIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-13",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "NP287090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.