Tyler Tantisook, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

63587 Issued in TN

Practice address

2525 Desales Ave
Chattanooga, TN 37404-1161

Phone

(423) 697-0014

Fax

(423) 648-6280

NPI assigned

Apr 11, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, TN, FL3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Georgia Emergency Associates

  • Emergency Medicine Physician
  • Rincon, GA
  • NPI 1528098290

  Emergency Medicine, GA

  Medicare reassignment Care Compare group NPD
• Chattanooga Emergency Medicine PLLC

  • Emergency Care Clinic/Center
  • Chattanooga, TN
  • NPI 1174739908

  GA

  Medicare reassignment NPD
• Chattanooga Emergency Medicine PLLC

  • Emergency Care Clinic/Center
  • Hixson, TN
  • NPI 1427264126

  TN

  Medicare reassignment NPD
• Anava Emergency Consultants LLC

  • Emergency Care Clinic/Center
  • Macclenny, FL
  • NPI 1003698184

  FL

  Medicare reassignment NPD
• Baker County Medical Services, Inc

  • Emergency Medicine Physician
  • Macclenny, FL
  • NPI 1578822508

  Emergency Medicine, FL

  Medicare reassignment NPD
• SGMC Affiliated Services LLC

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1114740362

  GA

  Medicare reassignment NPD
• South Georgia Emergency Medicine Associates PC

  • Emergency Medicine Physician
  • Thomasville, GA
  • NPI 1386903649

  Emergency Medicine, GA

  Medicare reassignment NPD
• Baker County Medical Services Inc

  • Rural Health Clinic/Center
  • Macclenny, FL
  • NPI 1386082220
  NPD
• Anava Hospitalists LLC

  • Hospitalist Physician
  • Macclenny, FL
  • NPI 1932096625
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Candler Hospital Incorporated

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1275527889

  Hospital

  Care Compare affiliation
• Saint Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1063406684

  Hospital

  Care Compare affiliation
• South Georgia Medical Center Inc

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553

  Hospital

  Care Compare affiliation

Specialty

Emergency Medicine

Education

University of Tennessee, HSC, College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Emergency Associates 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SGMC Health Hospital, Valdosta, GA, CCN 110122
• St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043
• Candler Hospital Hospital, Savannah, GA, CCN 110024

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1326545823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DR STE E487",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041173",
            "telephone_number": "423-697-0014",
            "fax_number": "423-648-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041161",
            "telephone_number": "423-697-0014",
            "fax_number": "423-648-6280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2051 Hamill Rd",
            "address_purpose": "LOCATION",
            "city": "Hixson",
            "state": "TN",
            "postal_code": "373436614",
            "country_code": "US",
            "telephone_number": "423-697-0014",
            "fax_number": "423-648-6280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Gross Crescent Cir",
            "address_purpose": "LOCATION",
            "city": "Fort Oglethorpe",
            "state": "GA",
            "postal_code": "307423643",
            "country_code": "US",
            "telephone_number": "423-697-0014",
            "fax_number": "423-648-6280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANTISOOK",
        "first_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "86971",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "63587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley Talley, RN
• Gregory Ugale Tambio
• Kellie Tankersley, PA-C
• Bryan Tanner, CRNA
• Christine Barrett Tanner, MA, NCC
• John E Tapp II, MD
• Tara L Hewlett-Bryant
• Tareck a. Kadrie, M.D., PLLC
• Ezekiel Tarrant, MD
• Tartesos PLLC

• All providers in Chattanooga, TN
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.