Tina Thibault Vincent, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN163999 NP Issued in GA

Practice address

4757 Netherstone CT NE
Marietta, GA 30066-6908

Phone

(678) 494-8939

Fax

(678) 264-2236

NPI assigned

May 13, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tina Marie Thibault Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242172800000",
    "number": "1508090903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4757 NETHERSTONE CT NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666908",
            "telephone_number": "678-494-8939",
            "fax_number": "678-264-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4757 NETHERSTONE CT NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666908",
            "telephone_number": "678-494-8939",
            "fax_number": "678-264-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "TINA",
        "middle_name": "THIBAULT",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2009-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN163999 NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "THIBAULT",
            "middle_name": "MARIE",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Village Podiatry Group, LLC
• Village Podiatry Group, LLC
• Village Podiatry Group, P.C.
• David R Villasana, MD
• Brant S Vincent, MD
• Lucretia Benee Vinson
• Valerie Vinton, APRN
• Kevin Peter Vinzani, D.C.
• Trish A Vinzani, D.C
• Victoria B Viola

• Family Nurse Practitioner in Marietta, GA
• Providers in Marietta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; 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.