Tiffany Nicole Parks, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

68594 Issued in GA

Practice address

3001 Gordon Hwy
Grovetown, GA 30813-3808

Phone

(706) 855-4700

NPI assigned

Apr 29, 2009

Last updated

Oct 24, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351036800000",
    "number": "1336383751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 GORDON HWY",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308133808",
            "telephone_number": "706-855-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 GORDON HWY",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308133808",
            "telephone_number": "706-855-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "TIFFANY",
        "middle_name": "NICOLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2012-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "68594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Outlaw, LCSW-C, LCSW, LISW-C
• Chelsea Nicole Overby, PMHNP
• Ronald Edwin Owens II, DMD
• Kyley Pahe, MS, RD, LD
• Terance Parker
• Wallace Allen Partridge Jr., PHARMACIST
• Jay M. Patel, PHARM.D.
• Paterson Pediatric Therapy LLC
• Patriots Park Dental
• Peacceful at Home LLC

• Internal Medicine Physician in Grovetown, GA
• Providers in Grovetown, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.