Tiffany Sammons Petrey, AGACNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN249240 Issued in GA

Practice address

206 Hospital Dr Ste a
Dublin, GA 31021-2560

Phone

(478) 275-3525

NPI assigned

Jul 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, MD, DC3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Georgia Cardiology Associates PCGroup PAC ID 7810985645, 8 clinicians

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairview Park Hospital Hospital, Dublin, GA, CCN 110125
• Medstar Saint Mary'S Hospital Hospital, Leonardtown, MD, CCN 210028
• Medstar Washington Hospital Center Hospital, Washington, DC, CCN 090011

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tpetrey2954215@carolinashealthcaresystem.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Georgia Cardiology Associates PC

  • Specialist
  • Macon, GA
  • NPI 1124077946
  Medicare reassignment Care Compare group NPD
• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187

  DC

  Medicare reassignment Care Compare group NPD
• Medstar Medical Group II LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1376887844
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fairview Park, Limited Partnership

  • General Acute Care Hospital
  • Dublin, GA
  • NPI 1285688234
  Care Compare affiliation
• Medstar Washington Hospital Center

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1548378235
  Care Compare affiliation
• St Marys Hospital of St Marys County Inc

  • General Acute Care Hospital
  • Leonardtown, MD
  • NPI 1780650473
  Care Compare affiliation

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1992313902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 HOSPITAL DR STE A",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 HOSPITAL DR STE A",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212560",
            "telephone_number": "478-275-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETREY",
        "first_name": "TIFFANY",
        "middle_name": "SAMMONS",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN249240",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN249240",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN249240",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN249240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Jean Penny, KINESIOTHERAPIST
• Sheila Perkins, NP
• James D Peters, D.O.
• Valerie L Peters, MS, RD, LD
• Susan L Petrey, MA/CCCA
• Julie Pettis, FNP
• April S Phillips, BSHA
• Karen Lord Phillips, PT
• Physician Consultants of Georgia Dublin
• Physicians Staffing Solutions

• Nurse Practitioner in Dublin, GA
• Providers in Dublin, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.