Individual provider Active NPI

Tiffany Ann Gibbert, PA-C

  • Physician Assistant
  • Macon, GA
National Provider Identifier
1407081581
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5577 Issued in GA
Practice address
260 Trotters Run
Macon, GA 31210-8653
Phone
(858) 337-0498
Fax
(478) 750-7756
NPI assigned
May 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5577 GA Primary

Addresses

Primary practice location

260 Trotters Run
Macon, GA 31210-8653

Mailing address

PO Box 26096
Macon, GA 31221-6096
Phone (478) 750-7780

Other practice location 1

PO Box 26096
Macon, GA 31221-6096
Phone (478) 750-7780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090629000177 GA Practitioner - Physician Assistant 6406907658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Services of Central GeorgiaGroup PAC ID 9638076730, 300 clinicians

Practice addresses (Care Compare)

1120 Morningside Dr
Perry, GA 31069-2906
Phone (478) 987-3600

520 W Ponce de Leon Ave
Suite 1706
Decatur, GA 30030-9998
Phone (404) 907-3292

520 W Ponce de Leon Avenue
Suite 1706
Decatur, GA 30030-9998

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Atlanta First Assist, LLC Past Accepting new patients
Northside Surgical Professional Services LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tiffany.gibbert.p47@direct.tenet.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1407081581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26096",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312216096",
            "telephone_number": "478-750-7780",
            "fax_number": "478-750-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 TROTTERS RUN",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312108653",
            "telephone_number": "858-337-0498",
            "fax_number": "478-750-7756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 26096",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312216096",
            "country_code": "US",
            "telephone_number": "478-750-7780",
            "fax_number": "478-750-7756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBERT",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "5577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.