Individual provider Active NPI

Julie Tiegs, FNP

  • Family Nurse Practitioner
  • Gainesville, GA
National Provider Identifier
1821641416
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06190382 Issued in GA
Practice address
5431 Little River Cir
Gainesville, GA 30506-3191
Phone
(615) 295-0788
NPI assigned
Jul 22, 2019
Last updated
Jul 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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 F06190382 GA Primary

Addresses

Primary practice location

5431 Little River Cir
Gainesville, GA 30506-3191

Mailing address

5431 Little River Cir
Gainesville, GA 30506-3191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220125000065 GA Practitioner - Nurse Practitioner 2860884806 Reassigns benefits to 1 organization
I20240719000569 MN Practitioner - Nurse Practitioner 2860884806 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
Rejuv Medical PAGroup PAC ID 2264598077, 15 clinicians

Practice addresses (Care Compare)

901 3Rd St N
Waite Park, MN 56387-1964
Phone (320) 217-8480

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F06190382GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rejuv Medical, P.a. Family CurrentSince May 14, 2024 Accepting new patients
Centennial Joint Care Inc CurrentSince Feb 1, 2022 Accepting new patients

Locations

1235 Friendship Rd
Ste 115
Braselton, GA 30517
Phone (770) 679-3090

901 3rd St N
Waite Park, MN 56387
Phone (320) 217-8480

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/32275/brand/1/csg/1/fhir/r4
  • Direct secure messaging: julie.tiegs.1@32275.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1821641416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5431 LITTLE RIVER CIR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305063191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5431 LITTLE RIVER CIR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305063191",
            "telephone_number": "615-295-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEGS",
        "first_name": "JULIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F06190382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.