Individual provider Active NPI

Tiffany Fern Gartrell, M.D.

  • Psychiatry Physician
  • Austell, GA
National Provider Identifier
1962791491
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
76036 Issued in GA
Practice address
1625 Hospital South Dr Ste 150
Austell, GA 30106-8111
Phone
(470) 732-6950
NPI assigned
Apr 5, 2011
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 76036 GA Primary
Forensic Psychiatry Physician 2084F0202X 76036 GA

Addresses

Primary practice location

1625 Hospital South Dr Ste 150
Austell, GA 30106-8111

Mailing address

1625 Austell Road
Austell, GA 30106
Phone (470) 732-6950

Other practice location 1

3073 Panthersville Rd
Decatur, GA 30034-3800
Phone (404) 244-2472

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tgartrell528358@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230317000628 GA Practitioner - Psychiatry 1759755531 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Morehouse School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1625 Hospital N Dr
Suite 150
Austell, GA 30106-8111
Phone (770) 732-6950

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Behavioral Health and Developmental Disabilities CurrentSince Dec 3, 2022 Accepting new patients
Department of Behavioral Health & Developmental Disabilities, Ga CurrentSince Dec 3, 2022 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Aug 1, 2023 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Department of Behavioral Health and Developmental Disabilities Current Accepting new patients
Administrators of the Tulane Educational Fund Past Accepting new patients
Wellstar Cardiovascular Medicine, LLC PastSince Sep 1, 2023 Accepting new patients

Locations

3405 Old Savannah Rd
Augusta, GA 30906
Phone (705) 790-2030

3073 Panthersville Rd
Decatur, GA 30034
Phone (404) 243-2100

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

Organizations & group practices 7

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": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1962791491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 AUSTELL ROAD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "30106",
            "telephone_number": "470-732-6950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 HOSPITAL SOUTH DR STE 150",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068111",
            "telephone_number": "470-732-6950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3073 Panthersville Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300343800",
            "country_code": "US",
            "telephone_number": "404-244-2472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARTRELL",
        "first_name": "TIFFANY",
        "middle_name": "FERN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "76036",
            "primary": true
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "GA",
            "license": "76036",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgartrell528358@directwellstar.org",
            "affiliation": "N",
            "address_1": "1625 Hospital South Dr",
            "city": "Austell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301068111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.