SOUTHWELL SCHOOL CLINIC
NPI 1508428442
Nurse Practitioner - School in Tifton, GA

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

The NPI number for Tift Regional Health System Inc is 1508428442. It was assigned to this organization in the NPPES registry on July 1, 2019. The provider is doing business as Southwell School Clinic.

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

The primary specialty registered for this NPI is Nurse Practitioner, specializing in School, with taxonomy code 363LS0200X.

Active since July 01, 2019CLIA 11D2169076 · Waiver

1464 CARPENTER ROAD S, TIFTON, GA 31793(229) 353-2227(229) 388-9515 Get Directions Write a Review

NPPES record last updated: June 24, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 8, 2021, Nov 13, 2019, Jul 2, 2019 (3 updates tracked since 2019).

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About Southwell School Clinic NPPES

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

SOUTHWELL SCHOOL CLINIC (NPI 1508428442) is a healthcare organization registered as a school in Tifton, Georgia and active in the NPI registry since July 2019. The organization holds a CLIA Waiver certificate valid through July 15, 2027, maintains a secondary practice location in Tifton, and lists Christopher Dorman, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1508428442

Entity TypeOrganization

Primary Taxonomy363LS0200X

Legal Business NameTIFT REGIONAL HEALTH SYSTEM INC

Location Address1464 CARPENTER ROAD STifton, GA 31793

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

Phone(229) 353-2227

Fax(229) 388-9515

Organization SubpartNo

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

Enumeration DateJuly 1, 2019

Last NPPES UpdateJune 24, 20223 updates tracked since enumeration

NPPES CertifiedJune 24, 2022

✔ NPI 1508428442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · SchoolPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LS0200X

1464 CARPENTER ROAD S, Tifton, GA 31793

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Other Names 1

Doing Business AsSouthwell School Clinic

Secondary Practice Location 1

Location 1700 8th St WTifton, GA 31794-3803 · Phone (229) 353-3767

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 11D2169076

Southwell School Clinic · Tifton, GA

Active · expires Jul 15, 2027

CLIA Number11D2169076

Laboratory TypeSchool/Student Health Service

Certificate Effective DateJuly 16, 2025

Certificate Expiration DateJuly 15, 2027

Laboratory DirectorMargaret Richardson-Nixon

Laboratory Phone(229) 353-6121

Laboratory LocationSouthwell School Clinic700 8th Street W, Tifton, GA 31794

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

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 1508428442. It was assigned to this organization in the NPPES registry on July 1, 2019. The provider is doing business as Southwell School Clinic.

Where is Tift Regional Health System Inc located?

Tift Regional Health System Inc is located at 1464 Carpenter Road S, Tifton, GA 31793. The listed phone number is (229) 353-2227.

What is Tift Regional Health System Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in School, with taxonomy code 363LS0200X.

Does Tift Regional Health System Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2169076) is associated with this NPI, valid through July 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Tift Regional Health System Inc 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 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 June 24, 2022. 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.