Southwell Medical Community Health Center – Rural Health Clinic/Center, NPI 1649800111

Southwell Medical Community Health Center is a healthcare provider. based in Tifton, Georgia. specializing in Rural Health Clinic/Center. The NPI Number for Southwell Medical Community Health Center is 1649800111

Main info

Organization
Name
Southwell Medical Community Health Center
NPI
1649800111
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 Community Health Center

  • 907 18TH ST E STE 400

    TIFTON, GA 317943684

    Phone: (229) 353-3422

    Type: Mailing

  • 2735 CENTRAL AVE S

    TIFTON, GA 317945645

    Phone: (229) 388-5690

    Fax: (229) 388-5685

    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: 2020-07-17

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
O20200717001168ORural 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 31794)

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Reviews

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Frequently asked questions

What number should I use to identify Southwell Medical Community Health Center for billing?
Administrative and clinical systems typically use NPI 1649800111 for Southwell Medical Community Health Center.
Should I treat Southwell Medical Community Health Center as an active provider?
Patients and plans typically see Southwell Medical Community Health Center as active in the national extract.
Which specialty label fits Southwell Medical Community Health Center?
NPPES ties Southwell Medical Community Health Center to Rural Health Clinic/Center in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit Southwell Medical Community Health Center in Tifton, Georgia?
For routing, start with Tifton, Georgia for Southwell Medical Community Health Center, then verify phone and hours locally.
Can I export Southwell Medical Community Health Center's record?
You can download the official NPPES record; we summarize key fields for readability.

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