NPIMap

Organization Active NPI

Tift Regional Health System Inc

Doing business as WorkSmart Occupational Medicine

  • Clinic/Center
  • Tifton, GA
National Provider Identifier
1003980996
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
137-180 Issued in GA
Legal business name
TIFT REGIONAL HEALTH SYSTEM INC
Doing business as
WorkSmart Occupational Medicine
Practice address
4468 Union Rd
Tifton, GA 31794-8331
Phone
(229) 353-6320
Fax
(229) 353-6343
NPI assigned
Nov 20, 2006
Last updated
Nov 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Authorized official

Name
Kristy Gladden
Title
Provider Enrollment Manager
Phone
(229) 353-3402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 137-180 GA Primary

Addresses

Primary practice location

4468 Union Rd
Tifton, GA 31794-8331

Mailing address

4468 Union Rd
Tifton, GA 31794-8331
Phone (229) 353-6320

Other identifiers 1

IdentifierTypeStateIssuer
137-180OtherGALICENSE NUMBER

Other names 1

  • WorkSmart Occupational Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200217002409 GA Part B Supplier - Clinic/Group Practice 2062745169 Receives reassigned benefits from 389 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tifton, GA; Adel, GA

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2029429Tift Regional Health System, Inc4468 Union Road, Tifton, GA 31794Certificate of waiverSep 7, 2027

National Provider Directory

National Provider Directory
Tax ID family
Tift Regional Health System Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

1111 20th St E
Tifton, GA 31794
Phone (229) 382-9338

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

1602 Madison Ave
Tifton, GA 31794
Phone (229) 386-4200

1803 Old Ocilla Rd
Tifton, GA 31794
Phone (229) 386-2181

2735 Central Ave S
Tifton, GA 31794
Phone (229) 388-5690

4468 Union Rd
Tifton, GA 31794
Phone (229) 353-6320

618 Central Ave N
Tifton, GA 31794
Phone (229) 353-6330

700 8th St W
Tifton, GA 31794
Phone (229) 353-3767

907 18th St E
Tifton, GA 31794
Phone (229) 353-3422

Practitioners & affiliated clinicians

Practitioners 355

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 355

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700524800000",
    "number": "1003980996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4468 UNION RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317948331",
            "telephone_number": "229-353-6320",
            "fax_number": "229-353-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4468 UNION RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317948331",
            "telephone_number": "229-353-6320",
            "fax_number": "229-353-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFT REGIONAL HEALTH SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A",
        "authorized_official_last_name": "GLADDEN",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "229-353-3402"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "137-180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "137-180",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WorkSmart Occupational Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.