Southwell Medical Sylvester Primary Care – Rural Health Clinic/Center, NPI 1487284956

Southwell Medical Sylvester Primary Care is a healthcare provider. based in Tifton, Georgia. specializing in Rural Health Clinic/Center. The NPI Number for Southwell Medical Sylvester Primary Care is 1487284956

Main info

Organization
Name
Southwell Medical Sylvester Primary Care
NPI
1487284956
Phone
(229) 353-3422
Address
907 18TH ST E STE 400
Authorized Official
CHRISTOPHER DORMAN PRESIDENT/CEO
Enumeration Date
23 January 2020
Last Update Date
24 June 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness80
Years active:6State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Southwell Medical Sylvester Primary Care

  • 907 18TH ST E STE 400

    TIFTON, GA 317943684

    Phone: (229) 353-3422

    Type: Mailing

  • 1010 W FRANKLIN ST

    SYLVESTER, GA 317911900

    Phone: (229) 776-3500

    Fax: (229) 777-8269

    Type: Location

  • PO BOX 2650

    TIFTON, GA 317932650

    Phone: (229) 353-3422

    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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-06-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Revalidation scheduled

Earliest CMS due date is 2026-10-31 (143 days away).

Enrollment records

1

Earliest due date

2026-10-31

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
O20200615003362ORural Health ClinicGA2026-10-31

What to do next

  • Monitor the published due date as it approaches.
  • Plan to revalidate in PECOS within the window CMS allows before the due date.
  • Verify the date on the CMS Revalidation Lookup Tool before submitting.

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 31794)

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Reviews

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Frequently asked questions

Can I cross-check Southwell Medical Sylvester Primary Care using NPI 1487284956?
NPI 1487284956 belongs to Southwell Medical Sylvester Primary Care; compare other details if you need extra assurance.
Is Southwell Medical Sylvester Primary Care still an active registrant?
Southwell Medical Sylvester Primary Care carries an active NPI according to the public dataset.
What kind of doctor is Southwell Medical Sylvester Primary Care?
Southwell Medical Sylvester Primary Care is associated with Rural Health Clinic/Center in the directory — Clinical services aligned with this taxonomy classification.
Is Southwell Medical Sylvester Primary Care located near Tifton?
Southwell Medical Sylvester Primary Care currently maps to Tifton, Georgia in this extract.
Does Southwell Medical Sylvester Primary Care accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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