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TIFTAREA PEDIATRICS
NPI 1154081271
Pediatrics in Tifton, GA

Active since December 30, 2021CLIA 11D2256938 · Waiver
215 12TH ST W, TIFTON, GA 31794(912) 690-4043 Get Directions Write a Review

NPPES record last updated: November 2, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 2, 2022, Dec 30, 2021 (2 updates tracked since 2021).

About Tiftarea Pediatrics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIFTAREA PEDIATRICS (NPI 1154081271) is a healthcare organization registered as a pediatrics in Tifton, Georgia and active in the NPI registry since December 2021. The organization holds a CLIA Waiver certificate valid through March 29, 2028 and lists Mark Wilson, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1154081271
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameTIFTAREA PEDIATRICS
Location Address215 12TH ST WTifton, GA 31794-3923
Mailing Address215 12th St WTifton, GA 31794-3923 · (912) 690-4043
Phone(912) 690-4043
Organization SubpartNo
Authorized OfficialMark WilsonCo-owner · (229) 396-5335
Enumeration DateDecember 30, 2021
Last NPPES UpdateNovember 2, 20222 updates tracked since enumeration
NPPES CertifiedNovember 2, 2022
✔ NPI 1154081271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
215 12TH ST W, Tifton, GA 31794
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2256938

Tiftarea Pediatrics · Tifton, GA
Active · expires Mar 29, 2028
CLIA Number11D2256938
Laboratory TypePhysician Office
Certificate Effective DateMarch 30, 2026
Certificate Expiration DateMarch 29, 2028
Laboratory DirectorMark Wilson
Laboratory Phone(229) 396-5335
Laboratory LocationTiftarea Pediatrics215 West 12th Street, Tifton, GA 31794
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK DAVIS WILSON M.D.
Pediatrics
215 12TH ST W
TIFTON, GA 31794
Tift County (229) 396-5335
ELIZABETH L. WILSON PNP
Nurse Practitioner (Pediatrics)
215 12TH ST W
TIFTON, GA 31794
Tift County (229) 396-5335

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tiftarea Pediatrics's NPI number?

The NPI number for Tiftarea Pediatrics is 1154081271. It was assigned to this organization in the NPPES registry on December 30, 2021.

Where is Tiftarea Pediatrics located?

Tiftarea Pediatrics is located at 215 12th St W, Tifton, GA 31794. The listed phone number is (912) 690-4043.

What is Tiftarea Pediatrics's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Tiftarea Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2256938) is associated with this NPI, valid through March 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Tiftarea Pediatrics accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Tiftarea Pediatrics as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tiftarea Pediatrics was last updated on November 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.