Individual provider Active NPI

Tiffanie Leigh-Anne Evans

  • Physician Assistant
  • Roswell, GA
National Provider Identifier
1942999214
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12971 Issued in GA
Practice address
1360 Upper Hembree Rd Ste 201B
Roswell, GA 30076-1230
Phone
(770) 475-3361
Fax
(770) 664-4431
NPI assigned
May 3, 2023
Last updated
Apr 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12971 GA Primary

Addresses

Primary practice location

1360 Upper Hembree Rd Ste 201B
Roswell, GA 30076-1230

Mailing address

1360 Upper Hembree Rd Ste 201B
Roswell, GA 30076-1230
Phone (770) 475-3361

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tevans615730@directwellstar.org

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
I20250314003207 GA Practitioner - Physician Assistant 4587186945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Morehouse School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1360 Upper Hembree Rd
Roswell, GA 30076-1230

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2912

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12971GAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Apr 15, 2025 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 15, 2025 Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

1360 Upper Hembree Rd
Ste 201B
Roswell, GA 30076
Phone (770) 225-1874

Interoperability endpoints

  • Direct secure messaging: tevans615730@directwellstar.org

Organizations & group practices 3

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": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1942999214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 UPPER HEMBREE RD STE 201B",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761230",
            "telephone_number": "770-475-3361",
            "fax_number": "770-664-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 UPPER HEMBREE RD STE 201B",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761230",
            "telephone_number": "770-475-3361",
            "fax_number": "770-664-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "TIFFANIE",
        "middle_name": "LEIGH-ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tevans615730@directwellstar.org",
            "affiliation": "N",
            "address_1": "1360 Upper Hembree Rd Ste 201B",
            "city": "Roswell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300761230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.