Active NPI
Tiffany Monet Fondren, PT, DPT
- Physical Therapist
- Cartersville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT013610
- Practice address
- 150 Gentilly Blvd
Cartersville, GA 30120-8522 - Phone
- (678) 719-7000
- NPI assigned
- Aug 23, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT013610 | GA | Primary |
Addresses
Primary practice location
150 Gentilly Blvd
Cartersville, GA 30120-8522
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Other names 1
- Dr. Tiffany Monet Lambert-Lucas
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, TX
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1180 E Prosper TRL
Suite 50
Prosper, TX 75078-5511
Phone (469) 481-3031
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9261 | SC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ideal Physical Therapy of Texas LLC | Physical Therapist | Current | Accepting new patients |
| Greenville Proaxis Therapy LLC | Current | Accepting new patients | |
| Ideal Physical Therapy of Texas LLC | Current | Accepting new patients | |
| Greenville Proaxis Therapy, LLC | Physical Therapist | Current | Accepting new patients |
Locations
790 Remington Blvd
Bolingbrook, IL 60440
33205 Collection Ctr Dr
Chicago, IL 60693
103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753
1305 S Suber Rd
Greer, SC 29650
Phone (864) 989-4609
315 Medical Pkwy
Ste 150
Greer, SC 29650
Phone (864) 695-1418
4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325
1555 US Highway 380
Ste 900
Frisco, TX 75033
Phone (972) 346-5634
8845 Gary Burns Dr
Ste 100
Frisco, TX 75034
Phone (469) 403-2090
6828 Stonebrook Pkwy
Ste 300
Frisco, TX 75034
Phone (469) 403-2022
2180 FM 423
Ste 300
Little Elm, TX 75068
Phone (469) 403-2242
3241 S Custer Rd
Ste 101
McKinney, TX 75070
3520 W University Dr
Ste 201
McKinney, TX 75071
Phone (469) 307-5674
1180 E Prosper Trl
Ste 50
Prosper, TX 75078
Phone (469) 481-3031
5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949
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.
-
- Physical Therapist
- Plano, TX
- NPI 1538573746
-
- Physical Therapist
- Greenville, SC
- NPI 1669457859
-
- Durable Medical Equipment & Medical Supplies
- Greenville, SC
- NPI 1740052000
-
- Durable Medical Equipment & Medical Supplies
- Murphy, TX
- NPI 1902773161
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1609357177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 GENTILLY BLVD",
"city": "CARTERSVILLE",
"state": "GA",
"postal_code": "301208522",
"telephone_number": "678-719-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONDREN",
"first_name": "TIFFANY",
"middle_name": "MONET",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-23",
"last_updated": "2024-07-22",
"certification_date": "2024-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT013610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TIFFANY",
"last_name": "LAMBERT-LUCAS",
"middle_name": "MONET",
"prefix": "DR.",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Cartersville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.