Individual provider Active NPI

Angela Lynn Vannortwick, N.P.

  • Family Nurse Practitioner
  • Tifton, GA
National Provider Identifier
1083148092
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN127277 Issued in GA
Practice address
2227 US Highway 41 N
Tifton, GA 31794-2749
Phone
(229) 391-3320
Fax
(229) 391-3325
NPI assigned
Apr 17, 2017
Last updated
Apr 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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 RN127277 GA Primary

Addresses

Primary practice location

2227 US Highway 41 N
Tifton, GA 31794-2749

Mailing address

907 18TH St E Ste 400
Tifton, GA 31794-3684
Phone (229) 353-3422

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address angelavanortwick@trhs.cernerdirect.com

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
I20170509003012 GA Practitioner - Nurse Practitioner 3870870397

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tift Regional Health System Inc CurrentSince May 3, 2017 Accepting new patients
Tift Regional Health System Inc CurrentSince May 3, 2017 Accepting new patients

Locations

2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422

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

907 18th St E
Ste 150
Tifton, GA 31794
Phone (229) 353-3422

907 18th St E
Ste 400
Tifton, GA 31794

907 18th St E
Ste 490
Tifton, GA 31794
Phone (229) 391-3320

Interoperability endpoints

  • Direct secure messaging: angelavanortwick@trhs.cernerdirect.com

Organizations & group practices 2

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": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1083148092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 18TH ST E STE 400",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943684",
            "telephone_number": "229-353-3422",
            "fax_number": "229-353-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2227 US HIGHWAY 41 N",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317942749",
            "telephone_number": "229-391-3320",
            "fax_number": "229-391-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNORTWICK",
        "first_name": "ANGELA",
        "middle_name": "LYNN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN127277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "angelavanortwick@trhs.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2227 US Highway 41 N",
            "city": "Tifton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317942749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.