Individual provider Active NPI

Tyler B. Vines, MD

  • Neurology Physician
  • Augusta, GA
National Provider Identifier
1730618729
Registry record updated Jun 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
009036 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-0004
Phone
(706) 721-4581
NPI assigned
Jun 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 009036 GA Primary

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-0004

Mailing address

1120 15TH St
Augusta, GA 30912-0004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210519001342 GA Practitioner - NeurologyPractitioner - Psychiatry 5395019541 Reassigns benefits to 2 organizations
I20210817000567 SC Practitioner - NeurologyPractitioner - Psychiatry 5395019541 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Psychiatry
Education
University of South Carolina School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, shared by 2 NPIs, 3,059 clinicians

Practice addresses (Care Compare)

1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623

118 Park Ave SW
Aiken, SC 29801-3835
Phone (706) 721-8623

450 Society Hill Dr
Aiken, SC 29803-1731
Phone (706) 721-8623

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009036GAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Jul 1, 2021 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Mar 1, 2024 Accepting new patients
Au Medical Associates Inc CurrentSince Jul 1, 2021 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

450 Society Hill Dr
Aiken, SC 29803
Phone (706) 722-4245

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

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.

Hospital & facility affiliations 4

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": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496620800000",
    "number": "1730618729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINES",
        "first_name": "TYLER",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2017-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "009036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.