Individual provider Active NPI

Madelyn Massey Burnette

  • Family Nurse Practitioner
  • Tifton, GA
National Provider Identifier
1669291449
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN299464 Issued in GA
Practice address
1909 US Highway 82 W Ste 5
Tifton, GA 31793-8213
Phone
(229) 386-4300
Fax
(229) 386-8300
NPI assigned
Oct 8, 2024
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN299464 GA Primary

Addresses

Primary practice location

1909 US Highway 82 W Ste 5
Tifton, GA 31793-8213

Mailing address

1909 US Highway 82 W Ste 5
Tifton, GA 31793-8213
Phone (229) 386-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20241219000684 GA Practitioner - Nurse Practitioner 7113454828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DMC Physician Group LLCGroup PAC ID 8628296845, 20 clinicians

Practice addresses (Care Compare)

116 Benjamin H Hill W Dr
Suite 12
Fitzgerald, GA 31750-9511
Phone (229) 424-7263

119 Norman Dorminy Dr
Suite C
Fitzgerald, GA 31750-9069
Phone (229) 423-5843

PO Box
Suite 1447
Fitzgerald, GA 31750

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN299464GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DMC Physician Group LLC CurrentSince Apr 28, 2025 Accepting new patients
DMC Physician Group LLC CurrentSince Apr 28, 2025 Accepting new patients
DMC Physician Group LLC Past Accepting new patients

Locations

417 Broad St S
Abbeville, GA 31001
Phone (229) 467-2171

119 Norman Dorminy Dr
Ste A
Fitzgerald, GA 31750
Phone (229) 423-1000

182 Perry House Rd
Ste H
Fitzgerald, GA 31750
Phone (229) 423-9561

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1669291449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 US HIGHWAY 82 W STE 5",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317938213",
            "telephone_number": "229-386-4300",
            "fax_number": "229-386-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 US HIGHWAY 82 W STE 5",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317938213",
            "telephone_number": "229-386-4300",
            "fax_number": "229-386-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETTE",
        "first_name": "MADELYN",
        "middle_name": "MASSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN299464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.