Tift Regional Health System, Inc.
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Tifton, GA
NPI 1831298660 · NPPES record last updated Aug 25, 2026
Key facts
- NPI
- 1831298660
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- TIFT REGIONAL HEALTH SYSTEM, INC.
- Practice address
- 1010 Edgefield Dr
Tifton, GA 31794-2408 - Phone
- (229) 353-6208
- Fax
- (229) 353-7722
- NPI assigned
- Sep 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Christopher Dorman
- Title
- President/Ceo
- Phone
- (229) 353-6104
Owned or controlled facilities with NPI records 8
Other NPIs with the same Medicare PAC ID 12
Corporate family (same tax ID) 19
Practitioners 294
-
Ronald Gary Adams, OTR/L, CHT
-
Madhurima Adulla, M.D
-
Ibrahim Al Marei, MD
-
Raymond Alvarez, DO
-
Robert Gregory Anderson, M.D.
-
Taylor M Anderson, PA-A
-
Luanne Ashton, FNP
-
Jerri K Aultman, RD
-
David M Banks, M.D.
-
Jessica Whitehead Beier, M.D.
-
Julie S Bennett, NP
-
Linsey Brooke Bennett, NP-C
-
Garrett Blalock, PA-C
-
Daniel Lock Boatright, CRNA
-
Penny D Booth, CFNP
-
Timantha D Booth, PA
Affiliated clinicians 2
Medicare Care Compare: Dialysis facility
- Listed as
- Tift Regional Medical Center Dialysis Center
- Overall star rating
- ★★☆☆☆ 2.0 of 5
- Ownership
- Non-profit
- Certified
- Sep 1, 1985
- Medicare certification status
- Active
- Dialysis stations
- 22
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0864322 | Tift Regional Dialysis Center | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
All facility ownership & control disclosures 8
| Facility | Type | Role | Since |
|---|---|---|---|
| Southwell Medical Sylvia Barr Center |
Hospital | Operational/Managerial Control | Jul 1, 2012 |
| Tift Regional Health System Inc |
Hospital | Operational/Managerial Control | Mar 1, 2019 |
| Southwell Health and Rehabilitation |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF Direct Ownership Interest (100%) |
Mar 1, 2019 Mar 1, 2019 May 15, 2025 Mar 1, 2019 |
| Southwell Medical Adel Primary Care |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2019 |
| Southwell Medical |
Rural health clinic | 5% Or Greater Direct Ownership Interest | Jul 12, 2012 |
| Southwell Medical Ashburn Primary Care |
Rural health clinic | 5% Or Greater Direct Ownership Interest | Jul 12, 2012 |
| Southwell Medical |
Rural health clinic | 5% Or Greater Direct Ownership Interest | Jul 12, 2012 |
| Southwell Medical Community Health |
Rural health clinic | 5% Or Greater Direct Ownership Interest | Jul 12, 2012 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190722000876 | GA | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 2062745169 | Practice locations: Tifton, GA |
National Provider Directory
- Tax ID family
- Tift Regional Health System Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
1010 Edgefield Dr
Tifton, GA 31794-2408
Mailing address
PO Box 2650
Tifton, GA 31793-2650
Phone (229) 353-3422
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ESRD001119 | Other | GA | STATE LICENSE |
| 000407338A | Medicaid | GA |
Other names
- Tift Regional Dialysis Center
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All providers in Tifton, GA · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.