Primary Care of Southwest Georgia- Bainbridge – Federally Qualified Health Center (FQHC), NPI 1821471277

Primary Care of Southwest Georgia- Bainbridge is a healthcare provider. based in Blakely, Georgia. specializing in Federally Qualified Health Center (FQHC). The NPI Number for Primary Care of Southwest Georgia- Bainbridge is 1821471277

Main info

Organization
Name
Primary Care of Southwest Georgia- Bainbridge
NPI
1821471277
Phone
(229) 723-2660
Address
360 COLLEGE ST
Authorized Official
MR. EDWIN JAMES CHIEF FINANCIAL OFFICER
Enumeration Date
2 July 2015
Last Update Date
2 July 2015
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness80
Years active:10State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Primary Care of Southwest Georgia- Bainbridge

  • 360 COLLEGE ST

    BLAKELY, GA 398232554

    Phone: (229) 723-2660

    Fax: (229) 723-5969

    Type: Mailing

  • 509 WHEAT AVE

    BAINBRIDGE, GA 398194321

    Phone: (229) 416-4421

    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: 2015-09-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-07-31 (313 days ago).

Enrollment records

1

Earliest due date

2025-07-31

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
O20150929002437OFederally Qualified Health Center (Fqhc)GA2025-07-31

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.

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 39823)

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Reviews

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Frequently asked questions

Is Primary Care of Southwest Georgia- Bainbridge listed with a National Provider Identifier?
Yes — Primary Care of Southwest Georgia- Bainbridge has NPI 1821471277 on file in the registry.
Active or inactive — what applies to Primary Care of Southwest Georgia- Bainbridge?
You should see Primary Care of Southwest Georgia- Bainbridge as active in CMS-hosted NPPES data.
What expertise is attributed to Primary Care of Southwest Georgia- Bainbridge?
Primary Care of Southwest Georgia- Bainbridge's specialty line reads Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
What locale is associated with Primary Care of Southwest Georgia- Bainbridge?
Directory geography for Primary Care of Southwest Georgia- Bainbridge centers on Blakely, Georgia.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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