SOUTH GEORGIA PHYSICIANS GROUP, LLC – Obstetrics & Gynecology Physician, NPI 1316501372
Obstetrics & Gynecology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SOUTH GEORGIA PHYSICIANS GROUP, LLC
1406 HABERSHAM DR
WAYCROSS, GA 315015306
Phone: (912) 287-1130
Fax: (912) 287-9114
Type: Location
3345 US HIGHWAY 84
SUITE 100
BLACKSHEAR, GA 315162160
Phone: (912) 632-2952
Type: Location
821 S. MAIN STREET
BAXLEY, GA 315135306
Phone: (912) 705-5483
Fax: (912) 705-5484
Type: Location
204, East 15th Street, Alma, Bacon County, Georgia, 31510, United States
ALMA, GA 315102908
Phone: (912) 632-2952
Fax: (912) 632-8682
Type: Mailing
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.
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 |
|---|---|---|---|---|
| O20110831000412 | O | Clinic/Group Practice | 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.
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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