Individual provider Active NPI

Clifford J Tumambing, MD

  • Family Medicine Physician
  • Lagrange, GA
National Provider Identifier
1992934640
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
68326 Issued in GA
Practice address
1698 Vernon Rd
Lagrange, GA 30240-4100
Phone
(706) 298-4937
NPI assigned
Jul 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL31844 SC
Hospitalist Physician 208M00000X 68326 GA
Family Medicine Physician 207Q00000X 68326 GA Primary

Addresses

Primary practice location

1698 Vernon Rd
Lagrange, GA 30240-4100

Mailing address

1698 Vernon Rd
Lagrange, GA 30240-4100
Phone (706) 298-4937

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
I20120926000090 GA Practitioner - HospitalistPractitioner - Family Practice 6002065653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Medical College of Georgia School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hometown Physician Group, LLCGroup PAC ID 1759678824, 7 clinicians

Practice addresses (Care Compare)

1399 Lafayette Pkwy
Lagrange, GA 30241-2572
Phone (706) 298-4937

1698 Vernon Rd
Lagrange, GA 30240-4100
Phone (706) 298-4937

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Columbus, GA, CCN 117318
  • Centerwell Home Health Home health agency, Columbus, GA, CCN 117056
  • West Georgia Home Care Home health agency, Lagrange, GA, CCN 117032
  • Wellstar West Georgia Medical Center Hospital, Lagrange, GA, CCN 110016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68326GAMDFamily Medicine Physician
LL31844SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Physician Group, LLC Family Medicine CurrentSince Dec 1, 2016 Accepting new patients

Locations

1698 Vernon Rd
Lagrange, GA 30240
Phone (706) 298-4937

1399 Lafayette Pkwy
Lagrange, GA 30241
Phone (706) 298-4937

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ICCJAD
  • Direct secure messaging: clifford.tumambing@westgahealth.gadirect.net
  • Direct secure messaging: ms_ctumambi@landmarkhealth-direct.org
  • Direct secure messaging: clifford.tumambing@htpg.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1992934640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404100",
            "telephone_number": "706-298-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1698 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404100",
            "telephone_number": "706-298-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMAMBING",
        "first_name": "CLIFFORD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL31844",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "68326",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "68326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.