Individual provider Active NPI

Tiffany Morgan, NP

  • Women's Health Nurse Practitioner
  • Canton, GA
National Provider Identifier
1023783099
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
104785844 Issued in GA
Practice address
1219 Univeter Rd
Canton, GA 30115-8261
Phone
(770) 345-7371
NPI assigned
Aug 12, 2021
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 104785844 GA Primary
Registered Nurse 163W00000X RN236819 GA

Addresses

Primary practice location

1219 Univeter Rd
Canton, GA 30115-8261

Mailing address

3200 Downwood Cir NW Ste 220
Atlanta, GA 30327-1611
Phone (404) 334-9103

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
I20250728000193 GA Practitioner - Nurse Practitioner 2567979321

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN236819GAMDRegistered Nurse
104785844GAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Gynecology CurrentSince Nov 21, 2021 Accepting new patients
Ideal Gynecology 2, LLC PastSince Nov 21, 2021 Accepting new patients
Pickens County Department of Public Health PastSince Aug 1, 2021 Accepting new patients

Locations

3200 Downwood Cir NW
Ste 220
Atlanta, GA 30327
Phone (404) 334-9103

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1023783099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 DOWNWOOD CIR NW STE 220",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303271611",
            "telephone_number": "404-334-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 UNIVETER RD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158261",
            "telephone_number": "770-345-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "TIFFANY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "104785844",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN236819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.