Community Primary Care Of Georgia Llc - Medicare Primary Care in Gray, GA

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Community Primary Care Of Georgia Llc is a medicare enrolled primary clinic (Family Medicine - Geriatric Medicine) in Gray, Georgia. The current practice location for Community Primary Care Of Georgia Llc is 1005 Boulder Dr, Gray, Georgia. For appointments, you can reach them via phone at (478) 621-2100. The mailing address for Community Primary Care Of Georgia Llc is 1005 Boulder Dr, Gray, Georgia and phone number is (478) 621-2100.

Community Primary Care Of Georgia Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1336492511. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (478) 621-2100.

Contact Information

Community Primary Care Of Georgia Llc
1005 Boulder Dr
Gray
GA 31032-6141
(478) 621-2100
(478) 744-0481

Map and Direction


Primary Care Clinic Profile

Full NameCommunity Primary Care Of Georgia Llc
SpecialityFamily Medicine
Location1005 Boulder Dr, Gray, Georgia
Authorized Official Name and PositionElize Joseph (DIRECTOR OF PRACTICE MANAGEMENT)
Authorized Official Contact4786212100
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Community Primary Care Of Georgia Llc
1005 Boulder Dr
Gray
GA 31032-6141

Ph: (478) 621-2100		Community Primary Care Of Georgia Llc
1005 Boulder Dr
Gray
GA 31032-6141

Ph: (478) 621-2100

NPI Details:

NPI Number1336492511
Provider Enumeration Date10/25/2012
Last Update Date06/28/2019

Medicare PECOS Information:

Medicare PECOS PAC ID0648421065
Medicare Enrollment IDO20121113000274

Medical Identifiers

Medical identifiers for Community Primary Care Of Georgia Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1336492511NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207QG0300XFamily Medicine - Geriatric Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Community Primary Care Of Georgia Llc acts as a billing entity for following providers:
Provider NameMary Mckinley
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1023003993
PECOS PAC ID: 0446163240
Enrollment ID: I20031107000483
Provider NameWyatt K Blake
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1548263064
PECOS PAC ID: 3274423348
Enrollment ID: I20040319001351
Provider NameBrick S Acosta
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1083607956
PECOS PAC ID: 4284624578
Enrollment ID: I20040518000177
Provider NameRobyn Allen Petagrew
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1144303280
PECOS PAC ID: 4880673664
Enrollment ID: I20040715000722
Provider NameRobert D Campbell
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1609843812
PECOS PAC ID: 2264407493
Enrollment ID: I20040831000662
Provider NameKirpich Joseph
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1750373023
PECOS PAC ID: 1456304286
Enrollment ID: I20050223000158
Provider NameMichael D Satchell
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1205822806
PECOS PAC ID: 4284673823
Enrollment ID: I20050503000344
Provider NameGrova L Satterfield
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1366410623
PECOS PAC ID: 7719929710
Enrollment ID: I20050602000115
Provider NameLuella C Wheeler Ikuesan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881611663
PECOS PAC ID: 4385653088
Enrollment ID: I20060407000152
Provider NameAmanda R White
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760538656
PECOS PAC ID: 3375635576
Enrollment ID: I20070817000135
Provider NameMelissa D. Primrose
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1457496234
PECOS PAC ID: 7012004435
Enrollment ID: I20071101000531
Provider NameMichael F Powell
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1932105699
PECOS PAC ID: 0143306670
Enrollment ID: I20080325000287
Provider NameRichard A Wherry
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1679558126
PECOS PAC ID: 0345306130
Enrollment ID: I20090303000339
Provider NameRalph Parks Warnock
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1942295712
PECOS PAC ID: 1355490038
Enrollment ID: I20100619000075
Provider NameBrenda Gail Tolleson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043402613
PECOS PAC ID: 0648359406
Enrollment ID: I20110414000592
Provider NameCalita S Hill
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528295078
PECOS PAC ID: 5193902302
Enrollment ID: I20110615000308
Provider NameConstance B Knowles
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821372236
PECOS PAC ID: 1951574037
Enrollment ID: I20111107000005
Provider NameLeslie B Miller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124339445
PECOS PAC ID: 9638330582
Enrollment ID: I20120419000673
Provider NameDianna L White
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578584256
PECOS PAC ID: 3678579026
Enrollment ID: I20120904000814
Provider NameFrances Amy Mccord
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821170572
PECOS PAC ID: 4688824576
Enrollment ID: I20121031000266
Provider NameAshley R Wilson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114252848
PECOS PAC ID: 6204089816
Enrollment ID: I20130110000195
Provider NameCatherine M Wilson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245584788
PECOS PAC ID: 8729231139
Enrollment ID: I20130116000124
Provider NameTrista Jacinta Marshall
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1346484763
PECOS PAC ID: 6507002250
Enrollment ID: I20131002000704
Provider NameBetty Riner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740629443
PECOS PAC ID: 3476796988
Enrollment ID: I20150115001758
Provider NameN'kema Cooper
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720475098
PECOS PAC ID: 8921230145
Enrollment ID: I20150702001920
Provider NameSherri Nation
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396137899
PECOS PAC ID: 3375861461
Enrollment ID: I20151208001039
Provider NameJennifer Clark
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265661045
PECOS PAC ID: 1052602349
Enrollment ID: I20160616000793
Provider NameAlexander C Ibezi-enendu
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1154615979
PECOS PAC ID: 3274832894
Enrollment ID: I20160706002548
Provider NameLisa Clark
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801160353
PECOS PAC ID: 8628988011
Enrollment ID: I20160719002203
Provider NameMarie Nozil
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164972188
PECOS PAC ID: 4688954886
Enrollment ID: I20161205002305
Provider NameShannon D. Coffee
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932650173
PECOS PAC ID: 5092097808
Enrollment ID: I20170130003105
Provider NameRebecca M Scruggs
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356893432
PECOS PAC ID: 5496948259
Enrollment ID: I20170222001470
Provider NameDavid A Smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477093177
PECOS PAC ID: 1850661968
Enrollment ID: I20170724000512
Provider NameGrace E Acero-smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528582061
PECOS PAC ID: 3971860784
Enrollment ID: I20171204002033
Provider NameJon R Teegardin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669955134
PECOS PAC ID: 1759622889
Enrollment ID: I20190417002833
Provider NameChristen S Weber
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1619395506
PECOS PAC ID: 7618219502
Enrollment ID: I20190424002033
Provider NameSarah R Purser
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356807507
PECOS PAC ID: 3375886492
Enrollment ID: I20190513001752
Provider NameMaulikkumar A Patel
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1013304088
PECOS PAC ID: 5092018390
Enrollment ID: I20190719000947
Provider NameMichael Kelly
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134781073
PECOS PAC ID: 4183952039
Enrollment ID: I20190829004133
Provider NameWhitney Jones
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609437359
PECOS PAC ID: 0143654384
Enrollment ID: I20191223000560
Provider NameKenya Lavette Fields
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1255975280
PECOS PAC ID: 6002244852
Enrollment ID: I20200310002075
Provider NameChrissy Latrice Farley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740828342
PECOS PAC ID: 2466883723
Enrollment ID: I20200520003702
Provider NameLatoya Venise Montfort
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528695137
PECOS PAC ID: 6800277179
Enrollment ID: I20220718002054
Provider NameKimberly Sheffield
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477270833
PECOS PAC ID: 9537532346
Enrollment ID: I20230227000373
Provider NameJose Rivera Sepulveda
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1225590821
PECOS PAC ID: 4284091927
Enrollment ID: I20230612000635
Provider NameCourtney Michelle Anderson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306621388
PECOS PAC ID: 5193189777
Enrollment ID: I20230914003758
Provider NameLelola Mcgirt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316517741
PECOS PAC ID: 4284088402
Enrollment ID: I20230921002753
Provider NameJasmine Teamer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760976153
PECOS PAC ID: 9638411457
Enrollment ID: I20240201003129

Reviews and Comments


Family Medicine in Gray, GA

Gray Family Health
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 110 Stone Brooke Dr, Gray, GA 31032
Phone: 478-986-4743    
Gray Family Health Llc
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 260 W Clinton St, Gray, GA 31032
Phone: 478-986-4743    Fax: 478-986-3921
Community Health Care Systems, Inc-jones
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 4292 Gray Hwy, Gray, GA 31032
Phone: 478-986-2500    Fax: 478-864-1288

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.