TIFT REGIONAL HEALTH SYSTEM INC
NPI 1366765166
Pediatrics in Tifton, GA

Q: What is Tift Regional Health System Inc's NPI number?

The NPI number for Tift Regional Health System Inc is 1366765166. It was assigned to this organization in the NPPES registry on March 8, 2010. The provider is doing business as Affinity Clinic.

Q: What is Tift Regional Health System Inc's specialty?

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

Active since March 08, 2010

39 KENT RD STE 5, TIFTON, GA 31794(229) 353-7337(229) 391-4051 Get Directions Write a Review

NPPES record last updated: November 6, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 6, 2025, Jun 3, 2021, Sep 18, 2020 and 3 more (6 updates tracked since 2017).

On this page

About Tift Regional Health System Inc NPPES

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

TIFT REGIONAL HEALTH SYSTEM INC (NPI 1366765166), doing business as Affinity Clinic, is a healthcare organization registered as a pediatrics in Tifton, Georgia and active in the NPI registry since March 2010. The organization maintains 3 additional practice locations and lists Christopher Dorman, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1366765166

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameTIFT REGIONAL HEALTH SYSTEM INC

Location Address39 KENT RD STE 5Tifton, GA 31794-1697

Mailing AddressPo Box 2650Tifton, GA 31793-2650 · (229) 353-3422

Phone(229) 353-7337

Fax(229) 391-4051

Organization SubpartNo

Authorized OfficialChristopher DormanPresident/ceo · (229) 353-6104

Enumeration DateMarch 8, 2010

Last NPPES UpdateNovember 6, 20256 updates tracked since enumeration

NPPES CertifiedNovember 6, 2025

✔ NPI 1366765166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ 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.

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedObstetrics & GynecologyTaxonomy 207V00000X

Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X

39 KENT RD STE 5, Tifton, GA 31794

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Other Names 1

Doing Business AsAffinity Clinic

Secondary Practice Locations 3

Location 11493 Kennedy Rd Ste ATifton, GA 31794-4178 · Phone (229) 391-4130 · Fax (229) 391-4138

Location 22227 US Highway 41 NTifton, GA 31794-2749 · Phone (229) 391-4110 · Fax (229) 391-4460

Location 3104 8th St W Unit ATifton, GA 31794-3985 · Phone (229) 391-4426 · Fax (229) 391-4304

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tift Regional Health System Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

559

Medicare enrollment records show 559 clinicians reassign Medicare billing to Tift Regional Health System Inc, which bills Medicare for the services they deliver. Of these, 16 practice at this address and 231 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 45

Nurse Practitioner119

Internal Medicine81

Family Practice38

Certified Registered Nurse Anesthetist (CRNA)37

Anesthesiology30

Gastroenterology21

Urology20

Hospitalist19

37 other specialties194

Nearest to this location (20)

See all 559

Dorothy Agyepong, CPNP

Nurse Practitioner

NPI 1821214909

39 KENT RD STE 5
Tifton, GA 31794

(229) 353-7337

✔ PECOSSame address

Lacey Childree, NP

Nurse Practitioner

NPI 1649161480

39 KENT RD STE 2
Tifton, GA 31794

(229) 353-4368

✔ PECOS✔ Accepts MedicareSame address

Dontre' Douse, MD

Otolaryngology

NPI 1396372694

39 KENT RD STE 2
Tifton, GA 31794

(229) 353-4368

✔ PECOS✔ Accepts MedicareSame address

Kelly Grummer-Smith, NP-C

Nurse Practitioner

NPI 1619310802

39 KENT RD STE 5
Tifton, GA 31794

(229) 353-7337

✔ PECOSSame address

Alisha Holloway, APRN

Nurse Practitioner

NPI 1992230023

39 KENT RD STE 5
Tifton, GA 31794

(229) 353-7337

✔ PECOSSame address

Kasey Mays, NP-C

Nurse Practitioner

NPI 1083288666

39 KENT RD STE 1
Tifton, GA 31794

(229) 391-4310

✔ PECOS✔ Accepts MedicareSame address

Sitarama Arvind Varma Mudunuru, MD

Nephrology

NPI 1952753253

39 KENT RD
Tifton, GA 31794

(404) 960-2817

✔ PECOS✔ Accepts MedicareSame address

Deidre Peacock, NP

Nurse Practitioner

NPI 1982094298

39 KENT RD STE 2
Tifton, GA 31794

(229) 388-9393

✔ PECOS✔ Accepts MedicareSame address

Emily Quinn, D.P.M.

Podiatry

NPI 1497011712

39 KENT RD
Tifton, GA 31794

(229) 382-3338

✔ PECOS✔ Accepts MedicareSame address

Priscilla Amoah, MD

Pediatric Medicine

NPI 1932556453

39 KENT RD STE 5
Tifton, GA 31794

(229) 353-7337

✔ PECOSSame address

Abduljalil Elfasi, MD

Nephrology

NPI 1154685550

39 KENT RD STE 1
Tifton, GA 31794

(229) 391-4310

✔ PECOS✔ Accepts MedicareSame address

Nikkia Johnson, MD

Pediatric Medicine

NPI 1750402731

39 KENT RD STE 5
Tifton, GA 31794

(229) 353-7337

✔ PECOSSame address

Shannon Price, M.D.

Obstetrics/Gynecology

NPI 1891718870

39 KENT ROAD
Tifton, GA 31794

(229) 391-4100

✔ PECOS✔ Accepts MedicareSame address

Flavia Rossi, M.D.

Pediatric Medicine

NPI 1225354525

39 KENT RD SUITE 5
Tifton, GA 31794

(229) 353-7337

✔ PECOSSame address

Brent Savelli, MD

Internal Medicine

NPI 1306878251

39 KENT RD SUITE 1
Tifton, GA 31794

(229) 391-3555

✔ PECOS✔ Accepts MedicareSame address

Nicholas Webster, M.D.

Pediatric Medicine

NPI 1619322328

39 KENT RD STE 5
Tifton, GA 31794

(229) 353-7337

✔ PECOSSame address

Robert Anderson, M.D.

Urology

NPI 1437119583

1815 OLD OCILLA RD
Tifton, GA 31794

(229) 391-3535

✔ PECOS✔ Accepts Medicare0.4 mi

Donald Menya, M.D.

Obstetrics/Gynecology

NPI 1194068601

1948 OLD OCILLA RD
Tifton, GA 31794

(229) 391-3500

✔ PECOS✔ Accepts Medicare0.4 mi

Christopher Pate, FNP

Nurse Practitioner

NPI 1740736263

1815 OLD OCILLA RD
Tifton, GA 31794

(229) 391-3535

✔ PECOS✔ Accepts Medicare0.4 mi

William Davis, MD

General Surgery

NPI 1497722193

1007 GREENFIELD DR
Tifton, GA 31794

(229) 382-9733

✔ PECOS✔ Accepts Medicare0.4 mi

See all 559 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Tift Regional Health System Inc's NPI number?

The NPI number for Tift Regional Health System Inc is 1366765166. It was assigned to this organization in the NPPES registry on March 8, 2010. The provider is doing business as Affinity Clinic.

Where is Tift Regional Health System Inc located?

Tift Regional Health System Inc is located at 39 Kent Rd Ste 5, Tifton, GA 31794. The listed phone number is (229) 353-7337.

What is Tift Regional Health System Inc's specialty?

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

Is Tift Regional Health System Inc enrolled in Medicare?

Yes. Tift Regional Health System Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tift Regional Health System Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 559 clinicians in 45 Medicare specialties reassign their Medicare billing to Tift Regional Health System Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (119), Internal Medicine (81) and Family Practice (38). Of these, 16 practice at this address and 231 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Tift Regional Health System Inc accept?

Health plans from Alliant Health Plans, Inc. list Tift Regional Health System Inc 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 Tift Regional Health System Inc was last updated on November 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.