EAR, NOSE AND THROAT CLINIC OF COFFEE CO. – Specialist, NPI 1891750774
Specialist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for EAR, NOSE AND THROAT CLINIC OF COFFEE CO.
Clackamas Community College, South Douglas Loop Road, Oregon City, Metro, Clackamas County, Oregon, 97045, United States
DOUGLAS, GA 315331068
Phone: (912) 384-2200
Fax: (912) 383-7992
Type: Mailing
Westside Drive, Douglas, Coffee County, Georgia, 31533, United States
DOUGLAS, GA 315330312
Phone: (912) 384-2200
Fax: (912) 383-7992
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: 2005-06-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-01-31 (862 days ago).
Enrollment records
1
Earliest due date
2024-01-31
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 |
|---|---|---|---|---|
| O20050620000687 | O | Clinic/Group Practice | GA | 2024-01-31 |
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 31533)
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