Organization Active NPI

Family Health Center of Tiftarea

  • Family Medicine Physician
  • Tifton, GA
National Provider Identifier
1689859720
Registry record updated Jan 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
049713 Issued in GA
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

Updated by the provider on Jan 8, 2008

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

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.

Verify at the official NPI Registry.