NPIMap

Organization Active NPI

Tift Regional Health System Inc.

Doing business as Tift Regional Medical Center

  • General Acute Care Hospital
  • Tifton, GA
National Provider Identifier
1962462226
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
137-180 Issued in GA
Legal business name
TIFT REGIONAL HEALTH SYSTEM INC.
Doing business as
Tift Regional Medical Center
Practice address
901 18TH St E
Tifton, GA 31794-3648
Phone
(229) 382-7120
NPI assigned
Mar 23, 2006
Last updated
Aug 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Authorized official

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

Specialties & licenses 1

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

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 names 1

  • Tift Regional Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA3 enrollments

Enrollment records 3

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962462226. Details of each certification follow.

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
CorporationNon-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

Other NPIs with the same Medicare PAC ID 12

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

Other NPIs on the same Medicare enrollment 28

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

View all 28

Care Compare: Hospital

Medicare Care Compare
Listed as
Tift Regional Medical CenterCCN 110095 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Interoperability endpoints

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

Ownership & related parties

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 DirectorSVP/Cfo Jun 27, 2022
W-2 Managing Employee Jun 27, 2022
John Brownlee Individual Corporate Director Nov 6, 2007

Owners & managing parties with NPI records 14

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

View all 14

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 CenterAdel, GA, CCN 11S101 Hospital Operational/Managerial Control Jul 1, 2012
Southwell Health and RehabilitationAdel, 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 CareAdel, GA, CCN 118528 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2019
Southwell MedicalSylvester, GA, CCN 118578 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 12, 2012
Southwell Medical Ashburn Primary CareAshburn, GA, CCN 118574 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 12, 2012
Southwell MedicalNashville, GA, CCN 118577 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 12, 2012
Southwell Medical Community HealthTifton, GA, CCN 118576 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 12, 2012

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 155

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 155

Affiliated clinicians 384

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

View all 384

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1962462226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 18TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943648",
            "telephone_number": "229-382-7120",
            "fax_number": "229-353-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 18TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943648",
            "telephone_number": "229-382-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFT REGIONAL HEALTH SYSTEM INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "DORMAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "229-353-6104"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "137-180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tift Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tift Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.