Tiffany Wilkerson Tullis

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

PCET004358 Issued in GA

Practice address

2 Mashburn St
Hawkinsville, GA 31036-4961

Phone

(478) 783-4460

NPI assigned

Aug 12, 2025

Last updated

Aug 12, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tiffany Ann Wilkerson Former name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Putnam General Hospital Authority

  dba Putnam General Hospital

  • Critical Access Hospital
  • Eatonton, GA
  • NPI 1386670834
  Medicare reassignment NPD
• Putnam General Hospital Authority

  dba Putnam General Hospital

  • Oxygen Equipment & Supplies (DME)
  • Eatonton, GA
  • NPI 1184810509
  NPD
• Elite Sport & Spine Physical Therapy, Inc.

  • Physical Therapist
  • Hawkinsville, GA
  • NPI 1518985282
  NPD (past)

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

{
    "created_epoch": "1754956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1184500779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5180 HAWKINS ACADEMY RD",
            "city": "SOCIAL CIRCLE",
            "state": "GA",
            "postal_code": "300254123",
            "telephone_number": "678-472-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MASHBURN ST",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310364961",
            "telephone_number": "478-783-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLIS",
        "first_name": "TIFFANY",
        "middle_name": "WILKERSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-12",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET004358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "WILKERSON",
            "middle_name": "ANN",
            "credential": "CF-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• The Oaks Nursing Home, Inc
• Keyondria Thomas
• Kyle Taylor Thombley, PHARMD
• Kyle Thompson, DPT
• Robert Thornton, CRNA
• W Wayne West OD PC
• Walgreen Co (Walgreens #12319)
• Walgreen Co (Rite Aid #3242)
• Haylee Ward, NP-C
• Colleen Wells

• Speech-Language Pathologist in Hawkinsville, GA
• Providers in Hawkinsville, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.