Active NPI
Family Health Center of Tiftarea
- Family Medicine Physician
- Tifton, GA
National Provider Identifier
1689859720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 049713
- Legal business name
- FAMILY HEALTH CENTER OF TIFTAREA
- Practice address
- 2016 Pineview Ave
Tifton, GA 31794-3035 - Phone
- (229) 387-9205
- Fax
- (229) 387-9254
- NPI assigned
- Jan 8, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Charolett Mittie Engram
- Title
- Practice Administrator
- Phone
- (229) 387-9205
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 049713 | GA | Primary |
Addresses
Primary practice location
2016 Pineview Ave
Tifton, GA 31794-3035
Mailing address
2016 Pineview Ave
Tifton, GA 31794-3035
Phone (229) 387-9205
National Provider Directory
National Provider DirectoryLocations
1493 Kennedy Rd
Ste B
Tifton, GA 31794
Phone (229) 387-9205
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Spartanburg, SC
- NPI 1619084308
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199750400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1199750400000",
"number": "1689859720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2016 PINEVIEW AVE",
"city": "TIFTON",
"state": "GA",
"postal_code": "317943035",
"telephone_number": "229-387-9205",
"fax_number": "229-387-9254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2016 PINEVIEW AVE",
"city": "TIFTON",
"state": "GA",
"postal_code": "317943035",
"telephone_number": "229-387-9205",
"fax_number": "229-387-9254"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY HEALTH CENTER OF TIFTAREA",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-08",
"last_updated": "2008-01-08",
"status": "A",
"authorized_official_last_name": "ENGRAM",
"authorized_official_first_name": "CHAROLETT",
"authorized_official_middle_name": "MITTIE",
"authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
"authorized_official_telephone_number": "229-387-9205",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "GA",
"license": "049713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tifton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.