Tiffany Blamble, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9842 Issued in GA

Practice address

4181 Hospital Dr NE Ste 204
Covington, GA 30014-2541

Phone

(770) 788-6534

NPI assigned

Apr 24, 2019

Last updated

Mar 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tiffany Sharpe Former name

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinnacle Orthopaedics and Sports Medicine Specialists LLCGroup PAC ID 6204723216, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
• Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tiffany.blamble.1@15749.direct.athenahealth.com

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.

• Pinnacle Orthopaedics & Sports Medicine Specialists LLC

  • Specialist
  • Marietta, GA
  • NPI 1194815175
  Medicare reassignment Care Compare group NPD
• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kennestone Hospital, Inc.

  dba Wellstar Kennestone Hospital

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation
• Kennestone Hospital, Inc.

  dba Wellstar Windy Hill Hospital

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1124682281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102321",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4181 HOSPITAL DR NE STE 204",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142541",
            "telephone_number": "770-788-6534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2235 Briarwood Way NE",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "GA",
            "postal_code": "30319",
            "country_code": "US",
            "telephone_number": "404-567-6944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3750 Venture Dr",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300961808",
            "country_code": "US",
            "telephone_number": "404-567-6944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAMBLE",
        "first_name": "TIFFANY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "SHARPE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hope Birdsong, RN, CNOR, RNFA
• Joy Elaine Bishop, RN, MSN, CPNP
• Darrell B Bittle, PTA
• Bivins Enterprise, LLC (Bivins Geriatric Healthcare)
• Soni Elizabeth Blackburn, LMSW
• Christy Blanchford, M.D.
• Destiny Blocker
• Jimmy Lee Blount, DDS
• Denicia Adoniya Boatswain
• Leon Bohanan Jr., RN

• Physician Assistant in Covington, GA
• Providers in Covington, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.