Individual provider Active NPI

Tiffany Payne, FNP-C

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1730645219
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN213553 Issued in GA
Practice address
371 E Paces Ferry Rd NE Ste 750
Atlanta, GA 30305-2372
Phone
(470) 419-4380
Fax
(470) 298-7736
NPI assigned
Feb 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 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 RN213553 GA Primary

Addresses

Primary practice location

371 E Paces Ferry Rd NE Ste 750
Atlanta, GA 30305-2372

Mailing address

371 E Paces Ferry Rd NE Ste 750
Atlanta, GA 30305-2372
Phone (470) 419-4380

Other practice location 1

550 Eagles Landing Pkwy Ste 204
Stockbridge, GA 30281-9082
Phone (678) 782-3866

Other practice location 2

300 Bullsboro Dr Ste Bc
Newnan, GA 30263-1680
Phone (770) 683-3230

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
I20190429001401 GA Practitioner - Nurse Practitioner 6204178965 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN213553GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beltline Bariatric and Surgical Group LLC PastSince Sep 3, 2016 Accepting new patients
Beltline Weight Loss LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1730645219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 E PACES FERRY RD NE STE 750",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052372",
            "telephone_number": "470-419-4380",
            "fax_number": "470-298-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 E PACES FERRY RD NE STE 750",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052372",
            "telephone_number": "470-419-4380",
            "fax_number": "470-298-7736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Eagles Landing Pkwy Ste 204",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302819082",
            "country_code": "US",
            "telephone_number": "678-782-3866",
            "fax_number": "470-298-7736",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Bullsboro Dr Ste Bc",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302631680",
            "country_code": "US",
            "telephone_number": "770-683-3230",
            "fax_number": "470-298-7732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "TIFFANY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN213553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.