NPIMap

Organization Active NPI

South Health District

Doing business as Tift County Board of Health

  • Public Health or Welfare Agency
  • Tifton, GA
National Provider Identifier
1356405351
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
SOUTH HEALTH DISTRICT
Doing business as
Tift County Board of Health
Practice address
305 12TH St E
Tifton, GA 31794-4011
Phone
(229) 386-8373
Fax
(229) 386-5075
NPI assigned
Dec 21, 2006
Last updated
May 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

Name
Mrs. Allie Pridgen
Title
District Administrator
Phone
(229) 333-5290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

305 12TH St E
Tifton, GA 31794-4011

Mailing address

PO Box 5147
Valdosta, GA 31603-5147
Phone (229) 333-5290

Other identifiers 4

IdentifierTypeStateIssuer
000457762CMedicaidGA
000052038JMedicaidGA
338807OtherGAWELLCARE
000452559HMedicaidGA

Other names 1

  • Tift County Board of Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050825000504 GA Part B Supplier - Mass Immunization (Roster Biller Only) 0648255018 13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lakeland, GA; Valdosta, GA; Tifton, GA; Statenville, GA; Quitman, GA; Ocilla, GA; Lake Park, GA; Hahira, GA…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
South Health District21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1356405351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5147",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316035147",
            "telephone_number": "229-333-5290",
            "fax_number": "229-333-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 12TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944011",
            "telephone_number": "229-386-8373",
            "fax_number": "229-386-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH HEALTH DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "ALLIE",
        "authorized_official_title_or_position": "DISTRICT ADMINISTRATOR",
        "authorized_official_telephone_number": "229-333-5290",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000457762C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000052038J",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "338807",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000452559H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tift County Board of Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.