Individual provider Active NPI

Brittney Tyus, NP-C

  • Family Nurse Practitioner
  • Bainbridge, GA
National Provider Identifier
1013306547
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN210080 Issued in GA
Practice address
721 E Shotwell St
Bainbridge, GA 39819-4063
Phone
(229) 400-9260
NPI assigned
Jan 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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 RN210080 GA Primary

Addresses

Primary practice location

721 E Shotwell St
Bainbridge, GA 39819-4063

Mailing address

721 E Shotwell St
Bainbridge, GA 39819-4063
Phone (229) 400-9260

Other identifiers 1

IdentifierTypeStateIssuer
003157590BMedicaidGA

Other names 1

  • Brittney London Former name

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
I20150423002058 GA Practitioner - Nurse Practitioner 3274851258 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

721 E Shotwell St
Bainbridge, GA 39819-4063
Phone (229) 400-9260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN210080GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
L&K Chiropractic Services LLC CurrentSince Nov 10, 2018 Accepting new patients
T & S Medical Services LLC CurrentSince Nov 1, 2021 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

922 S West St
Bainbridge, GA 39819
Phone (229) 248-8499

920 S West St
Bainbridge, GA 39819
Phone (229) 246-8850

721 E Shotwell St
Bainbridge, GA 39819
Phone (229) 220-7755

Organizations & group practices 3

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": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1013306547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194063",
            "telephone_number": "229-400-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194063",
            "telephone_number": "229-400-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYUS",
        "first_name": "BRITTNEY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN210080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003157590B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTNEY",
            "last_name": "LONDON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bainbridge, GA

Sources for this page

Verify at the official NPI Registry.