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AMANDA FAYE TISON APRN, FNP-C
NPI 1164088977
Nurse Practitioner - Family in Locust Grove, GA

Active since May 16, 2019PECOS Enrolled
4837 BILL GARDNER PKWY STE B, LOCUST GROVE, GA 30248(678) 800-1602 Get Directions Write a Review

NPPES record last updated: December 2, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 2, 2021, May 16, 2019 (2 updates tracked since 2019).

About Amanda Faye Tison Aprn, Fnp-c NPPES

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

AMANDA FAYE TISON APRN, FNP-C (NPI 1164088977) is an individual family provider in Locust Grove, Georgia, licensed in Georgia (GAA-NP000337) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Callahan.

NPPES Registry Identity

NPI1164088977
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameAMANDA FAYE TISONCredential: APRN, FNP-C
Location Address4837 BILL GARDNER PKWY STE BLocust Grove, GA 30248-3734
Mailing Address72 Bolingview RdJuliette, GA 31046-3932 · (904) 507-1221
Phone(678) 800-1602
Sole ProprietorNo
Enumeration DateMay 16, 2019
Last NPPES UpdateDecember 2, 20212 updates tracked since enumeration
NPPES CertifiedDecember 2, 2021
✔ NPI 1164088977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in GA · GAA-NP000337✔ Licensed in FL · 11002465
4837 BILL GARDNER PKWY STE B, Locust Grove, GA 30248
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Other Names 1

Former Name (1)Amanda Faye Thompson Rn

Secondary Practice Location 1

Location 1542325 US Highway 1Callahan, FL 32011-6496 · Phone (904) 507-1221

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Faye Tison Aprn, Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30248 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

CHRISTINE WILLIAMS BREEDEN NP-C
Nurse Practitioner (Family)
4837 BILL GARDNER PKWY STE B
LOCUST GROVE, GA 30248
Henry County (678) 800-1602

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 Amanda Tison's NPI number?

The NPI number for Amanda Tison is 1164088977. It was assigned to this individual provider in the NPPES registry on May 16, 2019. The provider is also known as Amanda Faye Thompson Rn.

Where is Amanda Tison located?

Amanda Tison practices at 4837 Bill Gardner Pkwy Ste B, Locust Grove, GA 30248. The listed phone number is (678) 800-1602.

What is Amanda Tison's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Amanda Tison enrolled in Medicare?

Yes. Amanda Tison is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Amanda Tison was last updated on December 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.