Individual provider Active NPI

Rhonda Tisdale, NP-BC

  • Family Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1508315102
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN217347 Issued in GA
Practice address
1751 Newnan Crossing Blvd E
Newnan, GA 30265-1517
Phone
(678) 423-5854
NPI assigned
Sep 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN217347 GA Primary

Addresses

Primary practice location

1751 Newnan Crossing Blvd E
Newnan, GA 30265-1517

Mailing address

1751 Newnan Crossing Blvd E.
Newnan, GA 30265
Phone (678) 423-5854

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
I20161229000922 GA Practitioner - Nurse Practitioner 0648551994 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians
Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

105 Collier Rd NW
Suite 5020
Atlanta, GA 30309-1731
Phone (404) 367-3210

2945 Panola Rd
Lithonia, GA 30038-2313
Phone (678) 732-1518

551 N Cherokee Rd
Social Circle, GA 30025-2887
Phone (678) 342-6000

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Professional Services, LLC CurrentSince Apr 16, 2018 Accepting new patients
American Current Care PA CurrentSince Dec 30, 2018 Accepting new patients
American Current Care P.a. CurrentSince Dec 30, 2018 Accepting new patients
Piedmont Medical Care Corporation CurrentSince Oct 1, 2024 Accepting new patients

Locations

688 Spring St NW
Atlanta, GA 30308
Phone (404) 881-1155

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

3580 Atlanta Ave
Hapeville, GA 30354
Phone (404) 768-3351

2945 Panola Rd
Stonecrest, GA 30038
Phone (678) 418-8101

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

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.

NPI Registry JSON

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

{
    "created_epoch": "1474761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508315102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 NEWNAN CROSSING BLVD E.",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "30265",
            "telephone_number": "678-423-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 NEWNAN CROSSING BLVD E",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651517",
            "telephone_number": "678-423-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "RHONDA",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN217347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.