Willacoochee Clinic – Rural Health Clinic/Center, NPI 1649670894

Willacoochee Clinic is a healthcare provider. based in Ocilla, Georgia. specializing in Rural Health Clinic/Center. The NPI Number for Willacoochee Clinic is 1649670894

Main info

Organization
Name
Willacoochee Clinic
NPI
1649670894
Phone
(229) 468-3800
Address
710 N IRWIN AVE
Authorized Official
KRYSTAL CARVER CFO
Enumeration Date
25 August 2014
Last Update Date
27 February 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness80
Years active:11State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Willacoochee Clinic

  • 710 N IRWIN AVE

    OCILLA, GA 317745011

    Phone: (229) 468-3800

    Fax: (229) 468-9991

    Type: Mailing

  • 134 FLEETWOOD AVE E

    WILLACOOCHEE, GA 316502730

    Phone: (912) 534-5142

    Fax: (912) 534-6120

    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: 2022-03-16

PECOS data refreshed: 2026-05-27

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20220316003013ORural Health ClinicGATBD

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.

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 31774)

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Reviews

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Frequently asked questions

Can I verify Willacoochee Clinic with an NPI only?
You can start verification with NPI 1649670894 for Willacoochee Clinic, then check state licensing separately.
Does CMS list Willacoochee Clinic as active?
Yes — Willacoochee Clinic is active in the NPI listing used on this page.
What taxonomy line describes Willacoochee Clinic?
For research purposes, treat Willacoochee Clinic as Rural Health Clinic/Center in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect Willacoochee Clinic on a map?
Expect Ocilla, Georgia as a primary anchor for Willacoochee Clinic unless the record lists multiple sites.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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