NPIMap

Organization Active NPI

Tift Regional Health System Inc

Doing business as Tift Regional Outpatient Therapy

  • Physical Therapist
  • Tifton, GA
National Provider Identifier
1164925855
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
TIFT REGIONAL HEALTH SYSTEM INC
Doing business as
Tift Regional Outpatient Therapy
Practice address
2227 US Highway 41 N
Tifton, GA 31794
Phone
(229) 353-6188
Fax
(229) 353-6309
NPI assigned
Mar 9, 2018
Last updated
Jun 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Authorized official

Name
Christopher Dorman
Title
President/Ceo
Phone
(229) 353-6104

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

2227 US Highway 41 N
Tifton, GA 31794

Mailing address

PO Box 2650
Tifton, GA 31793-2650
Phone (229) 353-3422

Other names 1

  • Tift Regional Outpatient Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200217002409 GA Part B Supplier - Clinic/Group Practice 2062745169 Receives reassigned benefits from 389 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tifton, GA; Adel, GA

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Tift Regional Health System Inc21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

104 8th St W
Unit A
Tifton, GA 31794
Phone (229) 391-4426

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656028800000",
    "number": "1164925855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2650",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317932650",
            "telephone_number": "229-353-3422"
        },
        {
            "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": "31794",
            "telephone_number": "229-353-6188",
            "fax_number": "229-353-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFT REGIONAL HEALTH SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-09",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A",
        "authorized_official_last_name": "DORMAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "229-353-6104"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tift Regional Outpatient Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.