Active NPI
Tina Renee Phillips
- Registered Nurse
- Senoia, GA
National Provider Identifier
1396621108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN276096
- Practice address
- 4111 Highway 54
Senoia, GA 30276-2625 - Phone
- (770) 238-6370
- Fax
- (770) 238-6370
- NPI assigned
- Aug 15, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN276096 | GA | Primary |
Addresses
Primary practice location
4111 Highway 54
Senoia, GA 30276-2625
Mailing address
4111 Highway 54
Senoia, GA 30276-2625
Phone (770) 238-6370
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN276096 | GA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755216000000",
"number": "1396621108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4111 HIGHWAY 54",
"city": "SENOIA",
"state": "GA",
"postal_code": "302762625",
"telephone_number": "770-238-6370",
"fax_number": "770-238-6370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4111 HIGHWAY 54",
"city": "SENOIA",
"state": "GA",
"postal_code": "302762625",
"telephone_number": "770-238-6370",
"fax_number": "770-238-6370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "TINA",
"middle_name": "RENEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-15",
"last_updated": "2025-08-15",
"certification_date": "2025-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GA",
"license": "RN276096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Senoia, GA
- Angela M Orenczak, IBCLC
- Palmetto Health Council Inc (YourTown Health)
- Paraclete Christian Counseling and Educational Services
- Leslie Isabel Perez, M.D.
- Michael Stuart Perry, M.A., L.P.C., N.C.C.
- Phoenix Rising Behavioral Health, LLC
- Kim Pogue, LCSW
- Publix Super Markets, Inc (Publix Pharmacy #1761)
- Redwood Counseling LLC
- Rock Surgical LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.