Individual provider Active NPI

Tiffany M Rouse, PA-C

  • Medical Physician Assistant
  • Blairsville, GA
National Provider Identifier
1760652283
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
003539 Issued in GA
Practice address
63 Pleasant Hill Rd
Blairsville, GA 30512-2291
Phone
(706) 745-2229
Fax
(706) 745-0836
NPI assigned
Mar 12, 2008
Last updated
Feb 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 003539 GA Primary

Addresses

Primary practice location

63 Pleasant Hill Rd
Blairsville, GA 30512-2291

Mailing address

PO Box 2239
Blairsville, GA 30514-2239
Phone (706) 745-2229

Other identifiers 1

IdentifierTypeStateIssuer
907254555BMedicaidGA

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
I20080519000030 GA Practitioner - Physician Assistant 2769551613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hillcrest Clinic, LLCGroup PAC ID 6901700152, 5 clinicians

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

401 Pat Haralson Dr
Unit 1
Blairsville, GA 30512-8409
Phone (706) 745-8790

63 Pleasant Hill Rd
Blairsville, GA 30512-2291
Phone (706) 745-2229

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003539GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Sep 22, 2020 Accepting new patients
Northwest Georgia Oncology Centers, PC Current Accepting new patients
High Mountain Health, PC Past Accepting new patients

Locations

1700 Hospital South Dr
Ste 300
Austell, GA 30106
Phone (770) 944-2830

63 Pleasant Hill Rd
Blairsville, GA 30512
Phone (706) 745-2229

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

144 Bill Carruth Pkwy
Ste 3100
Hiram, GA 30141
Phone (678) 363-1940

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBHGCA
  • Direct secure messaging: tiffany.rouse.1@8042.direct.athenahealth.com

Organizations & group practices 5

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 2

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": "1205280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1760652283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2239",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305142239",
            "telephone_number": "706-745-2229",
            "fax_number": "706-745-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 PLEASANT HILL RD",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305122291",
            "telephone_number": "706-745-2229",
            "fax_number": "706-745-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSE",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-12",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "907254555B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blairsville, GA

Sources for this page

Verify at the official NPI Registry.