NPIMap

Individual provider Active NPI

Haiden H Edore, NP-C

  • Primary Care Nurse Practitioner
  • Tifton, GA
National Provider Identifier
1306232491
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
NP210517 Issued in GA
Practice address
2225 US Highway 41 N
Tifton, GA 31794-2749
Phone
(229) 391-4100
NPI assigned
Apr 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NP210517 GA Primary

Addresses

Primary practice location

2225 US Highway 41 N
Tifton, GA 31794-2749

Mailing address

907 18TH St E Ste 400
Tifton, GA 31794-3684
Phone (229) 353-3422

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address haiden.edore@trhs.cernerdirect.com

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
I20150630001531 GA Practitioner - Nurse Practitioner 0345552618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tift Regional Health System IncGroup PAC ID 2062745169, 294 clinicians

Practice addresses (Care Compare)

901 18TH St E
Tifton, GA 31794-3648
Phone (229) 382-7120

Hospital & facility affiliations

  • Tift Regional Medical Center Hospital, Tifton, GA, CCN 110095
  • Southwell Medical, a Campus of TRMC Hospital, Adel, GA, CCN 110101

Merit-based Incentive Payment System (MIPS)

Final score
81.02 of 100Reported as group
Quality
57.87
Promoting interoperability
100
Improvement activities
40
Cost
75.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP210517GAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tift Regional Health System Inc CurrentSince Jul 1, 2015 Accepting new patients
Tift Regional Health System Inc CurrentSince Dec 1, 2019 Accepting new patients
Tift Regional Health System Inc Current Accepting new patients
Tift Regional Health System Inc CurrentSince Dec 1, 2019 Accepting new patients
Tift Regional Health System, Inc Current Accepting new patients
Tift Regional Health System Inc CurrentSince Jul 1, 2015 Accepting new patients

Locations

901 18th St E
Tifton, GA 31794
Phone (229) 353-6208

907 18th St E
Ste 150
Tifton, GA 31794
Phone (229) 353-3422

907 18th St E
Ste 400
Tifton, GA 31794

2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422

2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188

Interoperability endpoints

  • Direct secure messaging: haiden.edore@trhs.cernerdirect.com

Organizations & group practices 18

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.

View all 18

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": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1306232491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 18TH ST E STE 400",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943684",
            "telephone_number": "229-353-3422",
            "fax_number": "229-353-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 US HIGHWAY 41 N",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317942749",
            "telephone_number": "229-391-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDORE",
        "first_name": "HAIDEN",
        "middle_name": "H",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "NP210517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "haiden.edore@trhs.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2225 US Highway 41 N",
            "city": "Tifton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317942749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.