Individual provider Active NPI

Tiffany Griffin Peace, FNP

  • Family Nurse Practitioner
  • Atlanta, TX
National Provider Identifier
1114388113
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP133084 Issued in TX
Practice address
1011 S William St
Atlanta, TX 75551
Phone
(903) 796-2868
Fax
(903) 796-0826
NPI assigned
Mar 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-121823 AL
Family Nurse Practitioner 363LF0000X AP133084 TX Primary

Addresses

Primary practice location

1011 S William St
Atlanta, TX 75551

Mailing address

PO Box 1326
Marshall, TX 75671-1326
Phone (903) 927-3782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161213000069 AL Practitioner - Nurse Practitioner 1658650890 Reassigns benefits to 1 organization
I20170412001681 TX Practitioner - Nurse Practitioner 1658650890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians Southwest PAGroup PAC ID 1850204363, 188 clinicians

Practice addresses (Care Compare)

1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 597-0351

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-121823ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians Southwest, PA Family CurrentSince Apr 2, 2024 Accepting new patients
University of South Alabama CurrentSince Oct 29, 2016 Accepting new patients
University of South Alabama Current Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients
Camino Real Emergency Physicians PLLC Past Accepting new patients

Locations

2451 Fillingim St
Mobile, AL 36617
Phone (251) 434-3711

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

6210 S Broadway Ave
Tyler, TX 75703
Phone (903) 579-2700

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

Interoperability endpoints

  • Direct secure messaging: tgriffin355778@ahs.direct-ci.com

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 and National Provider Directory roles.

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": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1114388113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1326",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756711326",
            "telephone_number": "903-927-3782",
            "fax_number": "903-927-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 S WILLIAM ST",
            "city": "ATLANTA",
            "state": "TX",
            "postal_code": "75551",
            "telephone_number": "903-796-2868",
            "fax_number": "903-796-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACE",
        "first_name": "TIFFANY",
        "middle_name": "GRIFFIN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-121823",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP133084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, TX

Sources for this page

Verify at the official NPI Registry.