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Tift Regional Health System Inc.

Organization Active NPI General Acute Care Hospital · Tifton, GA

NPI 1962462226 · NPPES record last updated Aug 19, 2024

Key facts

NPI
1962462226
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
License
137-180 (GA)
Legal business name
TIFT REGIONAL HEALTH SYSTEM INC.
Practice address
901 18TH St E
Tifton, GA 31794-3648
Phone
(229) 382-7120
NPI assigned
Mar 23, 2006
Organization subpart
No

Authorized official

Name
Christopher Dorman
Title
President/Ceo
Phone
(229) 353-6104

Owners & managing parties with NPI records 14

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 28

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 28

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 361

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 361

Affiliated clinicians 384

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 384

Medicare Care Compare: Hospital

Listed as
Tift Regional Medical Center CCN 110095
Overall star rating
★★★☆☆ 3 of 5
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
Active (Provider of Services file)
Emergency services
No

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in GA

Hospital certification: CCN 110095

Legal name
TIFT REGIONAL HEALTH SYSTEM INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 1, 2024
Beds
241 (176 certified)
Ownership / control type
Hospital district or authority
Organization structure
Corporation · Non-profit
Incorporated
Sep 30, 2019 in GA
Enrollment address
901 18TH St E
Tifton, GA 31794-3648
Main/Primary Hospital Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jessica W Beier
Individual 		Corporate Director Mar 1, 2019
George Hunt
Individual 		Corporate Director Nov 6, 2007
Tift Regional Health System Inc
Organization · Tifton, GA
Corporation, Non-profit 		Operational/Managerial Control Mar 1, 2019
Scott Fulp
Individual 		Corporate Director Mar 1, 2019
James W Scott
Individual 		Corporate Director Mar 1, 2019
Kristy Gladden
Individual 		W-2 Managing Employee Sep 17, 2002
Lenton C Daughtrey
Individual 		Corporate Director Mar 1, 2019
Troy Brooks
Individual 		Corporate Director
SVP/Cfo		 Jun 27, 2022
W-2 Managing Employee Jun 27, 2022
John Brownlee
Individual 		Corporate Director Nov 6, 2007

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Southwell Medical Sylvia Barr Center
Adel, GA · CCN 11S101		 Hospital Operational/Managerial Control Jul 1, 2012
Southwell Health and Rehabilitation
Adel, GA · CCN 115655		 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
Adel, GA · CCN 118528		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2019
Southwell Medical
Sylvester, GA · CCN 118578		 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 12, 2012
Southwell Medical Ashburn Primary Care
Ashburn, GA · CCN 118574		 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 12, 2012
Southwell Medical
Nashville, GA · CCN 118577		 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 12, 2012
Southwell Medical Community Health
Tifton, GA · CCN 118576		 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 12, 2012

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200122001561 GA Part a Provider - Hospital 2062745169 Practice locations: Tifton, GA
O20200217002409 GA Part B Supplier - Clinic/Group Practice 2062745169 Receives reassigned benefits from 389 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tifton, GA; Adel, GA
O20200224001260 GA Part B Supplier - Clinic/Group Practice 9234566779 Receives reassigned benefits from 16 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Adel, GA; Valdosta, GA; Tifton, GA

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: deidre.dorman@trhs.cernerdirect.com
  • Direct secure messaging: kathleen.richardson@trhs.cernerdirect.com
  • Direct secure messaging: dorothy.agyepong@trhs.cernerdirect.com
  • Direct secure messaging: tessamy.goodwin@trhs.cernerdirect.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 137-180 GA Yes

Addresses

Primary practice location

901 18TH St E
Tifton, GA 31794-3648

Mailing address

901 18TH St E
Tifton, GA 31794-3648
Phone (229) 382-7120

Other identifiers

IdentifierTypeStateIssuer
1708569MedicaidLA
TIF0095NMedicaidAL
1531063MedicaidMS
000001922AMedicaidGA

Other names

  • Tift Regional Medical Center Doing business as

Other providers in Tifton, GA

All providers in Tifton, GA · General Acute Care Hospital in Georgia

Sources for this page

Verify at the official NPI Registry.