Mr Gordon Brent Waters, MD - Medicare Family Practice in Blackshear, GA

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Mr Gordon Brent Waters, MD is a medicare enrolled "Family Medicine" physician in Blackshear, Georgia. He went to Medical College Of Georgia School Of Medicine and graduated in 2000 and has 24 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice St Vincent's Ambulatory Care Inc and his current practice location is 120 E Carter Ave, Blackshear, Georgia. You can reach out to his office (for appointments etc.) via phone at (912) 449-4426.

Mr Gordon Brent Waters is licensed to practice in Georgia (license number 052849) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1730109414.

Contact Information

Mr Gordon Brent Waters, MD
120 E Carter Ave,
Blackshear, GA 31516-1561
(912) 449-4426
(912) 449-1059

Map and Direction




Physician's Profile

Full NameMr Gordon Brent Waters
GenderMale
SpecialityFamily Practice
Experience24 Years
Location120 E Carter Ave, Blackshear, Georgia
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Gordon Brent Waters attended and graduated from Medical College Of Georgia School Of Medicine in 2000
  NPI Data:
  • NPI Number: 1730109414
  • Provider Enumeration Date: 07/19/2006
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 1951291301
  • Enrollment ID: I20040318000767

Medical Identifiers

Medical identifiers for Mr Gordon Brent Waters such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1730109414NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 052849 (Georgia)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Amedisys Home HealthWaycross, GAHome health agency
Hospice Satilla Of Mem HospWaycross, GAHospice
Mayo Clinic Health System In WaycrossWaycross, GAHospital
Wayne Memorial HospitalJesup, GAHospital
Harborview SatillaWaycross, GANursing home
Baptist Village, Inc.Waycross, GANursing home

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
St Vincent's Ambulatory Care Inc2860411188275

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Gordon Brent Waters allows following entities to bill medicare on his behalf.
Entity NameSt Vincent's Ambulatory Care Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1417987124
PECOS PAC ID: 2860411188
Enrollment ID: O20051129000302
Entity NameHospital Physician Services - Southeast Professional Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760410385
PECOS PAC ID: 5597774554
Enrollment ID: O20060419000545
Entity NamePrivia Medical Group Of Georgia Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013313857
PECOS PAC ID: 4284951542
Enrollment ID: O20150325000983

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Gordon Brent Waters is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Gordon Brent Waters, MD
120 E Carter Ave,
Blackshear, GA 31516-1561

Ph: (912) 449-4426		Mr Gordon Brent Waters, MD
120 E Carter Ave,
Blackshear, GA 31516-1561

Ph: (912) 449-4426

Reviews and Comments


Family Medicine Doctors in Blackshear, GA

Mr. Thomas W Davis, M.D.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 147 Longleaf Dr, Blackshear, GA 31516
Phone: 912-449-6243    
Ms. Susan Brickle, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 120 E Carter Ave, Blackshear, GA 31516
Phone: 912-449-4426    Fax: 912-449-1059
Jeffrey P. Davenport, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 120 Carter Ave, Blackshear Family Practice, Blackshear, GA 31516
Phone: 912-449-4426    
Mr. Donald B. Waters, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 120 E Carter Ave, Blackshear, GA 31516
Phone: 912-449-4426    Fax: 912-449-1517

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.