Individual provider Active NPI

Cherry Lee Tison, APRN

  • Acute Care Nurse Practitioner
  • Cedartown, GA
National Provider Identifier
1184062572
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN138701 Issued in GA
Practice address
424 N Main St
Cedartown, GA 30125-2644
Phone
(770) 748-2500
NPI assigned
Jun 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN138701 GA Primary

Addresses

Primary practice location

424 N Main St
Cedartown, GA 30125-2644

Mailing address

420 E 2ND Ave
Suite 103
Rome, GA 30161-3209
Phone (706) 509-3000

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
I20130726000070 GA Practitioner - Nurse Practitioner 0941441471 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

601 S 8TH St
Griffin, GA 30224-4213
Phone (770) 228-2721

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN138701GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Hospitalists Group, LLC CurrentSince Jan 15, 2017 Accepting new patients
Georgia Hospitalists Group, LLC CurrentSince Jan 15, 2017 Accepting new patients
Georgia Hospitalists Group, LLC Current Accepting new patients
Etowah Emergency Physicians, LLC CurrentSince Feb 28, 2017 Accepting new patients
Floyd Emergency Physicians, LLC Past Accepting new patients

Locations

2360 Rockmart Hwy
Cedartown, GA 30125
Phone (770) 748-2500

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: ctison913097@carolinashealthcaresystem.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 2

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": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1184062572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 2ND AVE",
            "address_2": "SUITE 103",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613209",
            "telephone_number": "706-509-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 N MAIN ST",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252644",
            "telephone_number": "770-748-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISON",
        "first_name": "CHERRY",
        "middle_name": "LEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN138701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedartown, GA

Sources for this page

Verify at the official NPI Registry.