Angela Tisdol

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN107183 Issued in GA

Practice address

116 Rosedale Ave
Thomasville, GA 31792-6655

Phone

(229) 228-6577

NPI assigned

Dec 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Community Care Health Network LLC

  dba Matrix Medical Network

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1576368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576368000000",
    "number": "1811535305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 LULLWATER RD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317073151",
            "telephone_number": "229-343-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 ROSEDALE AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926655",
            "telephone_number": "229-228-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDOL",
        "first_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-15",
        "last_updated": "2019-12-15",
        "certification_date": "2019-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN107183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie M Thompson, P.A.
• Wilbur Woodrow Thompson
• Timothy O Thomson, MD
• Janice Thornton
• Thrive Physical Therapy and Fitness LLC
• Todd a. Hanscom, DC, LLC (Chiropractic Solutions)
• Manuel Eduardo Torres Ontiveros, MD
• Daniel Jose Torres
• Total Renal Care Inc (Thomas County Home Training)
• Total Renal Care Inc. (Red Hills Dialysis)

• Family Nurse Practitioner in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.