AMANDA FAYE TISON (APRN, FNP-C) – Family Nurse Practitioner, NPI 1164088977
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for AMANDA FAYE TISON (APRN, FNP-C)
72 BOLINGVIEW RD
JULIETTE, GA 310463932
Phone: (904) 507-1221
Type: Mailing
4837 BILL GARDNER PKWY STE B
LOCUST GROVE, GA 302483734
Phone: (678) 800-1602
Type: Location
1, Callahan Road, Strong, Franklin County, Maine, 04983, United States
CALLAHAN, FL 320116496
Phone: (904) 507-1221
Type: Mailing
542325 US Highway 1
Callahan, FL 320116496
Phone: (904) 507-1221
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-12-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20211201000884 | I | Nurse Practitioner | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 79 | 11 | $0 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 70 | 18 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 49 | 46 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 40 | 28 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 34 | 17 | $0 |
Insurance plans in this area (ZIP 31046)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| - | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| - | MD | |
| - | AZ | |
| - | FL | |
| - | MD | |
| - | GA |
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