Individual provider Active NPI

Tanya Georges, APRN

  • Adult Medicine Physician
  • Port Saint Lucie, FL
National Provider Identifier
1508600057
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
APRN11029847 Issued in FL
Practice address
2278 SW Plymouth St
Port Saint Lucie, FL 34953-2379
Phone
(772) 349-8608
NPI assigned
Jun 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X APRN11029847 FL Primary
Adolescent Medicine (Family Medicine) Physician 207QA0000X APRN11029847 FL
Geriatric Medicine (Family Medicine) Physician 207QG0300X APRN11029847 FL

Addresses

Primary practice location

2278 SW Plymouth St
Port Saint Lucie, FL 34953-2379

Mailing address

2278 SW Plymouth St
Port Saint Lucie, FL 34953-2379
Phone (772) 349-8608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241009003791 FL Practitioner - Nurse Practitioner 9032640420 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11029847FLMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LFC Family Home Health Solutions Inc CurrentSince Aug 22, 2024 Accepting new patients
Prestige Group Home Inc CurrentSince Jun 23, 2024 Accepting new patients

Locations

2100 Nebraska Ave
Ste 113
Fort Pierce, FL 34950
Phone (772) 460-0321

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBGDCD

Organizations & group practices 2

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": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1508600057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2278 SW PLYMOUTH ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532379",
            "telephone_number": "772-349-8608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2278 SW PLYMOUTH ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532379",
            "telephone_number": "772-349-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGES",
        "first_name": "TANYA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "APRN11029847",
            "primary": true
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "FL",
            "license": "APRN11029847",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "APRN11029847",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.