Individual provider Active NPI

Tiffany Le, FNP

  • Family Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1215385703
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP210441 Issued in GA
Practice address
789 Church St NE Ste 200
Marietta, GA 30060-7238
Phone
(770) 881-7964
Fax
(770) 881-7929
NPI assigned
May 25, 2016
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-NP210441 GA Primary

Addresses

Primary practice location

789 Church St NE Ste 200
Marietta, GA 30060-7238

Mailing address

2476 Octavia LN
Marietta, GA 30062-4981
Phone (404) 414-5745

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
I20160912001901 GA Practitioner - Nurse Practitioner 9931495355 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

3999 Austell Rd
Suite 901
Austell, GA 30106-1160
Phone (770) 809-3032

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-NP210441GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Jul 1, 2017 Accepting new patients
Georgia Em-I Medical Services, LLC CurrentSince Jul 15, 2016 Accepting new patients
Georgia Em-I Medical Services PC CurrentSince Jul 15, 2016 Accepting new patients
Georgia Em-I Medical Services. LLC Current Accepting new patients
Wellstreet of Georgia PC PastSince Dec 24, 2023 Accepting new patients

Locations

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

3999 Austell Rd
Ste 901
Austell, GA 30106
Phone (770) 809-3032

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

789 Church St NE
Ste 200
Marietta, GA 30060
Phone (770) 881-7964

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1215385703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2476 OCTAVIA LN",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300624981",
            "telephone_number": "404-414-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 CHURCH ST NE STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607238",
            "telephone_number": "770-881-7964",
            "fax_number": "770-881-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "TIFFANY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-25",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP210441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.