MR. GEORGE WILLIAM IV DURRELL (PA-C) – Surgical Physician Assistant, NPI 1053144238

MR. GEORGE WILLIAM IV DURRELL (PA-C) is a healthcare provider. based in Franklin, Tennessee. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 12628 (GA). The NPI Number for MR. GEORGE WILLIAM IV DURRELL (PA-C) is 1053144238

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
MR. GEORGE WILLIAM IV DURRELL (PA-C)
NPI
1053144238
Phone
(912) 871-7100
Address
PO BOX 689022
Enumeration Date
22 August 2024
Last Update Date
4 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9124861482
Graduation Year
2024 (2 years ago)
PAC ID
6103352018
Group Practice PAC ID
7214068592
Professional Enrollment ID
I20241216000140
Address ID
GA304581683ST1499XRDXX300

Contacts

Secure Messaging
george.durrell.1@8824.direct.athenahealth.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness95
Years active:1State licenses:1Other names

4,431 PHYSICIAN ASSISTANT in GA

Provider Addresses for MR. GEORGE WILLIAM IV DURRELL (PA-C)

  • PO BOX 689022

    FRANKLIN, TN 370689022

    Phone: (912) 871-7100

    Fax: (912) 871-7110

    Type: Mailing

  • 1497 FAIR RD STE 200

    STATESBORO, GA 304580824

    Phone: (912) 871-7100

    Fax: (912) 871-7110

    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: 2024-12-16

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241216000140IPhysician AssistantGATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37068)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7214068592View full group profile
NameSpecialtyState
Nurse PractitionerGA
A N E S T H E S I O L O G YNC
Nurse PractitionerGA
Internal Medicine, GastroenterologyGA
Physician AssistantGA
Internal MedicineGA
Internal Medicine, Pediatric MedicineGA
Nurse PractitionerGA
Family PracticeGA
Family PracticeNC

Reviews

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Frequently asked questions

What is the 10-digit NPI for MR. GEORGE WILLIAM IV DURRELL (PA-C)?
MR. GEORGE WILLIAM IV DURRELL (PA-C) — NPI 1053144238 — is the standard way to identify this listing.
Does the file indicate MR. GEORGE WILLIAM IV DURRELL (PA-C) is practicing under active NPI?
Directory data currently reports MR. GEORGE WILLIAM IV DURRELL (PA-C) as active.
What healthcare role does MR. GEORGE WILLIAM IV DURRELL (PA-C) hold?
Scheduling teams often label MR. GEORGE WILLIAM IV DURRELL (PA-C) under Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
What area does MR. GEORGE WILLIAM IV DURRELL (PA-C) serve?
MR. GEORGE WILLIAM IV DURRELL (PA-C)'s listing highlights Franklin, Tennessee; more addresses can appear in NPPES.
Is the information about MR. GEORGE WILLIAM IV DURRELL (PA-C) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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