Individual provider Active NPI

Zachary Ryan Tippens, APRN

  • Family Nurse Practitioner
  • Canton, GA
National Provider Identifier
1760003842
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP239947 Issued in GA
Practice address
720 Transit Ave
Canton, GA 30114-2540
Phone
(770) 720-7000
Fax
(770) 720-7055
NPI assigned
Apr 30, 2020
Last updated
Apr 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-NP239947 GA Primary
Registered Nurse 163W00000X RN239947 GA

Addresses

Primary practice location

720 Transit Ave
Canton, GA 30114-2540

Mailing address

720 Transit Ave
Canton, GA 30114-2540
Phone (770) 720-7000

Other identifiers 2

IdentifierTypeStateIssuer
F02200533OtherAMERICAN ACADEMY OF NURSE PACTITIONERS
RN239947OtherGASTATE OF GEORGIA

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
I20200522001835 GA Practitioner - Nurse Practitioner 8426479783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

1275 Hwy 54 W
Suite 201
Fayetteville, GA 30214-4538
Phone (770) 461-3776

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN239947GAMDRegistered Nurse
APRN-NP239947GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Immediate Care FP, LLC CurrentSince Apr 15, 2020 Accepting new patients

Locations

3540 Cobb Pkwy NW
Acworth, GA 30101
Phone (770) 974-3911

1275 Highway 54 W
Ste 201
Fayetteville, GA 30214
Phone (770) 461-3776

590 Lanier Ave W
Fayetteville, GA 30214

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

Organizations & group practices 1

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 1

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": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1760003842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 TRANSIT AVE",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142540",
            "telephone_number": "770-720-7000",
            "fax_number": "770-720-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 TRANSIT AVE",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142540",
            "telephone_number": "770-720-7000",
            "fax_number": "770-720-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPPENS",
        "first_name": "ZACHARY",
        "middle_name": "RYAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-30",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP239947",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN239947",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PACTITIONERS",
            "identifier": "F02200533",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF GEORGIA",
            "identifier": "RN239947",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.