Optim Primary Care- Glennville – Rural Health Clinic/Center, NPI 1972762508

Optim Primary Care- Glennville is a healthcare provider. based in Savannah, Georgia. specializing in Rural Health Clinic/Center. The NPI Number for Optim Primary Care- Glennville is 1972762508

Main info

Organization
Name
Optim Primary Care- Glennville
NPI
1972762508
Phone
(912) 644-5300
Address
210 E DERENNE AVE
Authorized Official
MR. DAVID ALEX VILLA CEO
Enumeration Date
9 June 2008
Last Update Date
14 January 2026
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness90
Years active:18State licenses:0Digital endpoints

Provider Addresses for Optim Primary Care- Glennville

  • Savannah Christian Preparatory School, Oak Forest Drive, DeRenne Terrace, Savannah, Chatham County, Georgia, 31404, United States

    SAVANNAH, GA 314056736

    Phone: (912) 644-5300

    Fax: (912) 644-5260

    Type: Mailing

  • 440 MALL BLVD STE C

    SAVANNAH, GA 314064868

    Phone: (912) 644-3340

    Fax: (912) 644-5398

    Type: Mailing

  • 1000B NORTH VETERANS BLVD

    GLENNVILLE, GA 304278603

    Phone: (912) 654-4599

    Fax: (912) 654-4648

    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: 2008-09-15

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
O20080915000590ORural 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 31405)

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Reviews

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Frequently asked questions

What is Optim Primary Care- Glennville's NPI number?
Optim Primary Care- Glennville's NPI is 1972762508 — the number used across U.S. healthcare to identify this provider.
Would Optim Primary Care- Glennville appear as active to a payer?
You can treat Optim Primary Care- Glennville as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with Optim Primary Care- Glennville?
Optim Primary Care- Glennville's record emphasizes Rural Health Clinic/Center. Clinical services aligned with this taxonomy classification.
Is Optim Primary Care- Glennville located near Savannah?
Optim Primary Care- Glennville currently maps to Savannah, Georgia in this extract.
Does Optim Primary Care- Glennville accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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Optim Primary Care Metter

Rural Health Clinic/Center
460, Mall Boulevard, Grove Park, Savannah, Chatham County, Georgia, 31406, United States
NPI: 1285132415