HEART OF GEORGIA PRIMARY CARE, LLC – Family Nurse Practitioner, NPI 1780244301
Family Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for HEART OF GEORGIA PRIMARY CARE, LLC
3637 ABBEVILLE HWY
EASTMAN, GA 310237489
Phone: (478) 231-5948
Type: Mailing
Plaza Avenue, Eastman, Dodge County, Georgia, 31023, United States
EASTMAN, GA 310236786
Phone: (478) 374-5774
Type: Location
706 W Barnard St
Glennville, GA 304273017
Phone: (912) 822-1941
Fax: (912) 822-1945
Type: Location
150 E Peacock St Ste A
Cochran, GA 310147847
Phone: (478) 271-3200
Fax: (478) 271-3205
Type: Location
911 PLAZA AVE STE C
EASTMAN, GA 310236786
Phone: (478) 374-5774
Fax: (912) 374-9112
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: 2019-07-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-07-31 (678 days ago).
Enrollment records
1
Earliest due date
2024-07-31
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 |
|---|---|---|---|---|
| O20190722001169 | O | Clinic/Group Practice | GA | 2024-07-31 |
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 31023)
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