NPIMap

Individual provider Active NPI

Tiffany M Delice, M.D.

  • Psychiatry Physician
  • Valdosta, GA
National Provider Identifier
1619976891
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
054448 Issued in GA
Practice address
111 N Patterson St
Valdosta, GA 31601-5515
Phone
(229) 219-1831
Fax
(229) 219-1832
NPI assigned
Jul 19, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 054448 GA Primary

Addresses

Primary practice location

111 N Patterson St
Valdosta, GA 31601-5515

Mailing address

111 N Patterson St
Valdosta, GA 31601-5515
Phone (229) 219-1831

Other identifiers 1

IdentifierTypeStateIssuer
940567216FMedicaidGA

Other names 1

  • Tiffany M Kumpel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040913000224 GA Practitioner - PsychiatryPractitioner - Family Practice 9234106048 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Family Practice
Education
University of California, San Diego School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SGMP Southland, LLCGroup PAC ID 1153563770, 28 clinicians
Turning Point Care Center LLCGroup PAC ID 1052305786, 15 clinicians

Practice addresses (Care Compare)

2217 Pineview Dr
Valdosta, GA 31602-7316
Phone (229) 671-6700

2409 N Patterson St
Valdosta, GA 31602-2512
Phone (229) 219-1831

3015 Veterans Pkwy S
Moultrie, GA 31788-6705
Phone (229) 985-4815

Hospital & facility affiliations

  • Crescent Home Health Home health agency, Adel, GA, CCN 117087
  • SGMC Health Hospital, Valdosta, GA, CCN 110122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Greenleaf Center, LLC CurrentSince Jan 1, 2013 Accepting new patients
Turning Point Care Center LLC CurrentSince Dec 10, 2022 Accepting new patients
Integrative Health PC Psychiatry CurrentSince Jul 5, 2011 Accepting new patients
Choice Family Medicine, PC Current Accepting new patients
SGMP Southland LLC Psychiatry CurrentSince May 6, 2018 Accepting new patients
Turning Point Care Center LLC CurrentSince Dec 10, 2022 Accepting new patients
Valdosta Psychiatric Associates, LLC Psychiatry Past Accepting new patients
Better Mood Clinic S Ga LLC Past Accepting new patients
Hospital Authority of Valdosta and Lowndes County, Georgia Past Accepting new patients

Locations

3015 Veterans Pkwy S
Moultrie, GA 31788
Phone (229) 873-6479

2209 Pineview Dr
Valdosta, GA 31602
Phone (229) 247-4357

2217 Pineview Dr
Valdosta, GA 31602
Phone (229) 247-4357

201 Woodrow Wilson Dr
Valdosta, GA 31602
Phone (229) 241-0041

Interoperability endpoints

  • Direct secure messaging: tiffany.delice@4164.securemail.prognocis.com

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1619976891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316015515",
            "telephone_number": "229-219-1831",
            "fax_number": "229-219-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316015515",
            "telephone_number": "229-219-1831",
            "fax_number": "229-219-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELICE",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "054448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "940567216F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "KUMPEL",
            "middle_name": "M",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.