Individual provider Active NPI

Havila Tiyyagura

  • Student in an Organized Health Care Education/Training Program
  • Griffin, GA
National Provider Identifier
1396650446
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
113979 Issued in GA
Practice address
747 S 8TH St Ste B
Griffin, GA 30224-4884
Phone
(470) 604-8250
Fax
(770) 999-2814
NPI assigned
Aug 14, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 113979 GA Primary

Addresses

Primary practice location

747 S 8TH St Ste B
Griffin, GA 30224-4884

Mailing address

747 S 8TH St Ste B
Griffin, GA 30224-4884
Phone (470) 604-8250

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

NPI Registry JSON

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

{
    "created_epoch": "1786665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1396650446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 S 8TH ST STE B",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244884",
            "telephone_number": "470-604-8250",
            "fax_number": "770-999-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 S 8TH ST STE B",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244884",
            "telephone_number": "470-604-8250",
            "fax_number": "770-999-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIYYAGURA",
        "first_name": "HAVILA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-14",
        "last_updated": "2026-08-14",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "113979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.