NPIMap

Tift Regional Health System Inc

Organization Active NPI Orthopaedic Surgery Physician · Tifton, GA

NPI 1376920488 · NPPES record last updated Jun 24, 2022

Key facts

NPI
1376920488
Entity type
Organization (NPI type 2)
Primary specialty
Orthopaedic Surgery Physician 207X00000X
License
015420 (GA)
Legal business name
TIFT REGIONAL HEALTH SYSTEM INC
Practice address
2227 US Highway 41 N
Tifton, GA 31794-2749
Phone
(229) 386-5222
Fax
(229) 386-0900
NPI assigned
Apr 28, 2015
Organization subpart
No

Authorized official

Name
Christopher Dorman
Title
President/Ceo
Phone
(229) 353-6104

Other NPIs on the same Medicare enrollment 23

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

Corporate family (same tax ID) 19

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

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200217002409 GA Part B Supplier - Clinic/Group Practice 2062745169 Receives reassigned benefits from 389 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tifton, GA; Adel, GA

National Provider Directory

Tax ID family
Tift Regional Health System Inc (20 organizations share this tax ID)

Locations

1803 Old Ocilla Rd
Tifton, GA 31794
Phone (229) 386-2181

907 18th St E
#130
Tifton, GA 31794
Phone (229) 353-2284

Interoperability endpoints

  • Direct secure messaging: william.smith@trhs.cernerdirect.com
  • Direct secure messaging: edward.hellman@trhs.cernerdirect.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207X00000X 015420 GA Yes

Addresses

Primary practice location

2227 US Highway 41 N
Tifton, GA 31794-2749

Mailing address

PO Box 2650
Tifton, GA 31793-2650
Phone (229) 353-3422

Other practice location 1

2922 N Oak St Ste C
Valdosta, GA 31602-1885
Phone (229) 386-5222

Other names

  • Georgia Sports Medicine Doing business as

Other providers in Tifton, GA

All providers in Tifton, GA · Orthopaedic Surgery Physician in Georgia

Sources for this page

Verify at the official NPI Registry.