NPIMap

Organization Active NPI

DHP of Georgia PC

  • Obstetrics & Gynecology Physician
  • Athens, GA
National Provider Identifier
1578826988
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
DHP OF GEORGIA PC
Practice address
1230 Baxter St
Athens, GA 30606-3712
Phone
(999) 999-9999
NPI assigned
Jun 20, 2012
Last updated
Oct 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Authorized official

Name
Karen Melissa Tibedo
Title
National Director, Enrollment Opera
Phone
(865) 985-7130

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary
Hospitalist Physician 208M00000X

Addresses

Primary practice location

1230 Baxter St
Athens, GA 30606-3712

Mailing address

265 Brookview Centre Way Ste 203
Knoxville, TN 37919-4053
Phone (865) 693-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120925000305 GA Part B Supplier - Clinic/Group Practice 9931358520 Receives reassigned benefits from 12 practitioners
Practice locations: Athens, GA; Augusta, GA; Dublin, GA

National Provider Directory

National Provider Directory

Locations

808 Aviation Pkwy
Ste 1300
Morrisville, NC 27560

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759795200000",
    "number": "1578826988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 BROOKVIEW CENTRE WAY STE 203",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194053",
            "telephone_number": "865-693-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 BAXTER ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306063712",
            "telephone_number": "999-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHP OF GEORGIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-20",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A",
        "authorized_official_last_name": "TIBEDO",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "MELISSA",
        "authorized_official_title_or_position": "NATIONAL DIRECTOR, ENROLLMENT OPERA",
        "authorized_official_telephone_number": "865-985-7130"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.