Camilla Family Medicine – Primary Care Clinic/Center, NPI 1649449323

Camilla Family Medicine is a healthcare provider. based in Camilla, Georgia. specializing in Primary Care Clinic/Center. The organization holds a License No. 42685 (GA). The NPI Number for Camilla Family Medicine is 1649449323

Main info

Organization
Name
Camilla Family Medicine
NPI
1649449323
Phone
(229) 336-7343
Address
24 N ELLIS ST
Authorized Official
DR. RAYMOND J OTIS SR. OWNER MD
Enumeration Date
26 February 2008
Last Update Date
28 May 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness80
Years active:18State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Camilla Family Medicine

  • 24, North Ellis Street, Camilla, Mitchell County, Georgia, 31730, United States

    CAMILLA, GA 317301502

    Phone: (229) 336-7343

    Fax: (229) 336-7400

    Type: Mailing

  • PO BOX 348

    CAMILLA, GA 317300348

    Phone: (229) 336-7343

    Fax: (229) 336-7400

    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: 2003-12-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-06-30 (710 days ago).

Enrollment records

1

Earliest due date

2024-06-30

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
O20031202000140OClinic/Group PracticeGA2024-06-30

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 31730)

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Reviews

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Frequently asked questions

What is the standard ID for Camilla Family Medicine in the U.S.?
In the U.S., Camilla Family Medicine is identified by NPI 1649449323.
Does the public listing show Camilla Family Medicine as active?
Camilla Family Medicine's NPI record reflects an active status in NPPES.
How should patients interpret Camilla Family Medicine's specialty?
The extract shows Primary Care Clinic/Center for Camilla Family Medicine. Clinical services aligned with this taxonomy classification.
Which community is linked to Camilla Family Medicine?
Camilla Family Medicine shows a connection to Camilla, Georgia in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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