MEMORIAL SATILLA SPECIALISTS, LLC – General Practice Physician, NPI 1295266955

MEMORIAL SATILLA SPECIALISTS, LLC is a healthcare provider. based in Waycross, Georgia. specializing in General Practice Physician. The NPI Number for MEMORIAL SATILLA SPECIALISTS, LLC is 1295266955

Main info

Organization
Name
MEMORIAL SATILLA SPECIALISTS, LLC
NPI
1295266955
Phone
(912) 490-0722
Address
1921 ALICE ST STE B
Authorized Official
ROBERT ALI FAILE III AUTHORIZED OFFICIAL
Enumeration Date
24 March 2017
Last Update Date
24 March 2017
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:9State licenses:0Digital endpointsOther names

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Provider Addresses for MEMORIAL SATILLA SPECIALISTS, LLC

  • Alice Street, Waycross, Ware County, Georgia, 31501, United States

    WAYCROSS, GA 315016200

    Phone: (912) 490-0722

    Fax: (912) 490-7227

    Mailing address matches the actual address.

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: 2017-07-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-07-31 (1046 days ago).

Enrollment records

1

Earliest due date

2023-07-31

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
O20170706002072OClinic/Group PracticeGA2023-07-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 31501)

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Reviews

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Frequently asked questions

Is MEMORIAL SATILLA SPECIALISTS, LLC listed with a National Provider Identifier?
Yes — MEMORIAL SATILLA SPECIALISTS, LLC has NPI 1295266955 on file in the registry.
Is MEMORIAL SATILLA SPECIALISTS, LLC shown as active in public data?
Registry records indicate MEMORIAL SATILLA SPECIALISTS, LLC maintains an active NPI.
What expertise is attributed to MEMORIAL SATILLA SPECIALISTS, LLC?
MEMORIAL SATILLA SPECIALISTS, LLC's specialty line reads General Practice Physician. Clinical services aligned with this taxonomy classification.
Is MEMORIAL SATILLA SPECIALISTS, LLC located near Waycross?
MEMORIAL SATILLA SPECIALISTS, LLC currently maps to Waycross, Georgia in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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