SGMP SOUTHLAND LLC – Psychiatry Physician, NPI 1447695085
Psychiatry Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SGMP SOUTHLAND LLC
116 W Thigpen Ave
Suite D
Lakeland, GA 316351011
Phone: (229) 482-8585
Fax: (229) 482-8586
Type: Location
2927 Demere Rd
Saint Simons Is, GA 315221620
Phone: (229) 236-0831
Type: Location
1150 Cornell Ave
Savannah, GA 314062702
Phone: (229) 236-0831
Type: Location
201 Woodrow Wilson Dr
Valdosta, GA 316022538
Phone: (229) 469-5484
Type: Location
100 S Madison St
Thomasville, GA 317925473
Phone: (229) 236-0831
Fax: (229) 236-0871
Type: Location
201 WOODROW WILSON DR
VALDOSTA, GA 316022538
Phone: (229) 469-5484
Type: Location
PO BOX 1276
THOMASVILLE, GA 317991276
Phone: (229) 236-0831
Fax: (229) 236-0871
Type: Mailing
2209 PINEVIEW DR
VALDOSTA, GA 316027316
Phone: (229) 236-0831
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: 2023-10-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-01-31 (133 days ago).
Enrollment records
3
Earliest due date
2026-01-31
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 |
|---|---|---|---|---|
| O20130812000452 | O | Clinic/Group Practice | GA | TBD |
| O20200925001644 | O | Clinic/Group Practice | AL | 2026-01-31 |
| O20231024001078 | O | Clinic/Group Practice | FL | TBD |
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.
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 31635)
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