Individual provider Active NPI

Tiffany Le

  • Nurse Practitioner
  • Athens, GA
National Provider Identifier
1306540513
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN301700 Issued in GA
Practice address
3320 Old Jefferson Rd BLDG 800
Athens, GA 30607-1400
Phone
(706) 353-2990
Fax
(706) 353-2992
NPI assigned
Mar 30, 2023
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN301700 GA
Nurse Practitioner 363L00000X RN301700 GA Primary

Addresses

Primary practice location

3320 Old Jefferson Rd BLDG 800
Athens, GA 30607-1400

Mailing address

3431 Reagan Way
Lawrenceville, GA 30044-3496
Phone (334) 830-7122

Other practice location 1

1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 712-2000

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
I20250123000429 GA Practitioner - Nurse Practitioner 9032648894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3320 Old Jefferson Rd
Athens, GA 30607-1400
Phone (706) 353-2990

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN301700GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Cancer & Blood Center LLC CurrentSince Nov 11, 2024 Accepting new patients
University Health Alliance Past Accepting new patients

Locations

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

1230 Baxter St
Athens, GA 30606
Phone (706) 364-3100

3320 Old Jefferson Rd
Bldg 700
Athens, GA 30607
Phone (706) 224-6348

3320 Old Jefferson Rd
Bldg 800
Athens, GA 30607
Phone (706) 353-2290

3320 Old Jefferson Rd
Ste 600
Athens, GA 30607
Phone (706) 549-4155

110 Mercer Pl
Commerce, GA 30529
Phone (706) 335-2302

4182 Highway 278 NE
Covington, GA 30014
Phone (678) 712-6921

119 Harmony Xing
Ste 1
Eatonton, GA 31024
Phone (762) 220-1880

355 Clear Creek Pkwy
Ste 2007
Lavonia, GA 30553
Phone (706) 356-2934

2151 W Spring St
Ste B200
Monroe, GA 30655
Phone (770) 267-0724

3991 Highway 78 W
Ste 102
Snellville, GA 30039
Phone (706) 715-2010

1656 Falls Rd
Ste B
Toccoa, GA 30577
Phone (706) 886-0392

1460 Resurgence Dr
Watkinsville, GA 30677
Phone (706) 715-2410

295 N Broad St
Winder, GA 30680
Phone (678) 963-0939

Organizations & group practices 2

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 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": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1306540513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3431 REAGAN WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300443496",
            "telephone_number": "334-830-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 OLD JEFFERSON RD BLDG 800",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306071400",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1364 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221059",
            "country_code": "US",
            "telephone_number": "404-712-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "TIFFANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN301700",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN301700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.