Organization Active NPI

Palmetto Health Care Group LLC

  • Adult Health Nurse Practitioner
  • Tifton, GA
National Provider Identifier
1467327239
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
PALMETTO HEALTH CARE GROUP LLC
Practice address
212 8TH St E
Tifton, GA 31794-4058
Phone
(229) 396-5002
NPI assigned
Oct 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Authorized official

Name
Shelley Perry
Title
Owner
Phone
(229) 326-2645

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X Primary

Addresses

Primary practice location

212 8TH St E
Tifton, GA 31794-4058

Mailing address

212 8TH St E
Tifton, GA 31794-4058
Phone (229) 396-5002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260521004646 GA Part B Supplier - Clinic/Group Practice 5496225252 Receives reassigned benefits from 1 practitioner
Practice locations: Tifton, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1759968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1467327239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 8TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944058",
            "telephone_number": "229-396-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 8TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944058",
            "telephone_number": "229-396-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO HEALTH CARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-09",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-326-2645"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 9, 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.