NPIMap

Individual provider Active NPI

Tannis Alligood, MD

  • Family Medicine Physician
  • Nahunta, GA
National Provider Identifier
1265457717
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51288 Issued in GA
Practice address
71 Johnson St
Nahunta, GA 31553-4032
Phone
(912) 462-8920
Fax
(912) 462-5187
NPI assigned
Jul 13, 2006
Last updated
Jan 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 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 Medicine Physician 207Q00000X 51288 GA Primary

Addresses

Primary practice location

71 Johnson St
Nahunta, GA 31553-4032

Mailing address

705 Wells Rd Ste 300
Orange Park, FL 32073-2982
Phone (912) 462-8920

Other practice location 1

120 E Carter Ave
Blackshear, GA 31516-1561
Phone (912) 449-4426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040309000337 GA Practitioner - Family Practice 7618865858 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mercer University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Camden Healthcare Associates IncGroup PAC ID 8123013455, 10 clinicians

Practice addresses (Care Compare)

71 Johnson St
Nahunta, GA 31553-4032
Phone (912) 462-8920

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51288GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Oct 26, 2021 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Oct 26, 2021 Accepting new patients
Camden Healthcare Associates, Inc. Family Medicine CurrentSince May 1, 2024 Accepting new patients
Mayo Clinic Health System in Waycross, Inc. Past Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

705 Wells Rd
#300
Orange Park, FL 32073
Phone (904) 621-0671

120 E Carter Ave
Blackshear, GA 31516
Phone (912) 449-4426

120 E Carter Ave
Ste A
Blackshear, GA 31516
Phone (912) 449-4426

130 N Gross Rd
Ste 201
Kingsland, GA 31548
Phone (912) 729-2795

71 Johnson St
Nahunta, GA 31553
Phone (912) 462-8920

1506 Alice St
Waycross, GA 31501
Phone (912) 285-3086

1900 Tebeau St
Waycross, GA 31501
Phone (912) 283-3030

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25110/brand/1/csg/21/fhir/r4
  • Direct secure messaging: tannis.alligood.2@25110.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1265457717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 WELLS RD STE 300",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320732982",
            "telephone_number": "912-462-8920",
            "fax_number": "912-462-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 JOHNSON ST",
            "city": "NAHUNTA",
            "state": "GA",
            "postal_code": "315534032",
            "telephone_number": "912-462-8920",
            "fax_number": "912-462-5187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 E Carter Ave",
            "address_purpose": "LOCATION",
            "city": "Blackshear",
            "state": "GA",
            "postal_code": "315161561",
            "country_code": "US",
            "telephone_number": "912-449-4426",
            "fax_number": "912-449-1059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLIGOOD",
        "first_name": "TANNIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "51288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nahunta, GA

Sources for this page

Verify at the official NPI Registry.