Tift Regional Health System, Inc

Primary specialty

Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X

License

037-597 Issued in GA

Legal business name

TIFT REGIONAL HEALTH SYSTEM, INC

Doing business as

Cook Medical Center
Southwell Medical

Practice address

260 MJ Taylor Rd
Adel, GA 31620-3485

Phone

(229) 896-8000

NPI assigned

Jan 25, 2007

Last updated

Jun 24, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Dorman

Title

President/Ceo

Phone

(229) 353-6104

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Cook Medical Center Doing business as
• Southwell Medical Doing business as

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656028800000",
    "number": "1548315898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 MJ TAYLOR RD",
            "city": "ADEL",
            "state": "GA",
            "postal_code": "316203485",
            "telephone_number": "229-896-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 MJ TAYLOR RD",
            "city": "ADEL",
            "state": "GA",
            "postal_code": "316203485",
            "telephone_number": "229-896-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFT REGIONAL HEALTH SYSTEM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A",
        "authorized_official_last_name": "DORMAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "229-353-6104"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "GA",
            "license": "037-597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00001251S",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cook Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southwell Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas D Fausett Jr MD PC
• Kimberly Thompson
• Tia S Sanderlin MD PC
• Tift Regional Health System Inc (Cook Senior Living Center)
• Tift Regional Health System Inc (Southwell Specialty Clinic Adel)
• Tift Regional Health System, Inc. (Southwell Medical Sylvia Barr Center)
• Tift Regional Health System, Inc. (Southwell Medical)
• Tift Regional Health System, Inc. (Cook Primary Care)
• Amanda Hope Tillman, LMFT
• Tanya Tim

• Medicare Defined Swing Bed Hospital Unit in Adel, GA
• Providers in Adel, GA by specialty
• Medicare Defined Swing Bed Hospital Unit in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.