Deidre Cobb Tift, NP

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

RN081939 Issued in GA

Practice address

210 Garden Cir
Hinesville, GA 31313-4421

Phone

(912) 977-4643

Fax

(912) 369-6530

NPI assigned

Jul 16, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Serenity House PCH, Inc.

  • Marriage & Family Therapist
  • Hinesville, GA
  • NPI 1720396773
  NPD (past) Authorized official

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1487967618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 GARDEN CIR",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134421",
            "telephone_number": "912-977-4643",
            "fax_number": "912-369-6530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 GARDEN CIR",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134421",
            "telephone_number": "912-977-4643",
            "fax_number": "912-369-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIFT",
        "first_name": "DEIDRE",
        "middle_name": "COBB",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-16",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW003123",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN081939",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "GA",
            "license": "RN081939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Thornton
• Jayde Thornton
• Amanda Thrasher
• Tift & Tift LLC
• Charles Edwin Tift, LMSW, NCAC II, CCS
• Tamika Tigner
• Sabin Alexandru Tomus, M.D.
• Tiffany Torres-Graham, FNP
• Tamika Michelle Torres, PTA
• Total Renal Care Inc

• Obstetrics & Gynecology Nurse Practitioner in Hinesville, GA
• Providers in Hinesville, GA by specialty
• Obstetrics & Gynecology Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; 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.