South Central Primary Care | |
204 E 4th St Ocilla GA 31774-1539 | |
(229) 468-9166 | |
(229) 468-9188 |
Full Name | South Central Primary Care |
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Speciality | Clinic/Center |
Location | 204 E 4th St, Ocilla, Georgia |
Authorized Official Name and Position | R B Tucker (CFO) |
Authorized Official Contact | 2294689160 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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South Central Primary Care Po Box 749 Ocilla GA 31774-0749 Ph: (229) 468-9166 | South Central Primary Care 204 E 4th St Ocilla GA 31774-1539 Ph: (229) 468-9166 |
NPI Number | 1891978854 |
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Provider Enumeration Date | 12/13/2007 |
Last Update Date | 10/22/2024 |
Medicare PECOS PAC ID | 1951395920 |
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Medicare Enrollment ID | O20040413000249 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891978854 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Patricia F Patterson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629066915 PECOS PAC ID: 2062303415 Enrollment ID: I20040324000030 |
Provider Name | Tobi A Okafo |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1255383246 PECOS PAC ID: 3870596976 Enrollment ID: I20060810000113 |
Provider Name | Shirlene D Royal |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154545077 PECOS PAC ID: 6901935394 Enrollment ID: I20100524000249 |
Provider Name | Karuna Dyapa Reddy |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1396748984 PECOS PAC ID: 8820262439 Enrollment ID: I20111116000899 |
Provider Name | Amanda Merritt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760862346 PECOS PAC ID: 8527373216 Enrollment ID: I20150810001428 |
Provider Name | Kayla Phillips |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255784955 PECOS PAC ID: 7113212242 Enrollment ID: I20160829000355 |
Provider Name | Betty A Smith |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326583360 PECOS PAC ID: 3678850138 Enrollment ID: I20170510001747 |
Provider Name | Chinmay Patel |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1366859233 PECOS PAC ID: 4284994476 Enrollment ID: I20180208000693 |
Provider Name | Karen M Manac |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1508375932 PECOS PAC ID: 7911330659 Enrollment ID: I20191210002347 |
Provider Name | Joshua Caleb Vining |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487260949 PECOS PAC ID: 7719397496 Enrollment ID: I20201109001610 |
Provider Name | Shondra Shantel Holmes |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1649808296 PECOS PAC ID: 4082027966 Enrollment ID: I20210114000717 |
Provider Name | Jeffery Todd Stringer |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1629652201 PECOS PAC ID: 8022417773 Enrollment ID: I20210528001493 |
Provider Name | Sandra Sheffield |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1801391628 PECOS PAC ID: 1658620596 Enrollment ID: I20210921001526 |
Provider Name | Bobby Jean Musgrove |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710539911 PECOS PAC ID: 7214326776 Enrollment ID: I20211123000417 |
Provider Name | Maebry Paulk |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083386650 PECOS PAC ID: 8820488059 Enrollment ID: I20211202001715 |
Provider Name | Carolyn Eaves |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700425758 PECOS PAC ID: 5890190938 Enrollment ID: I20220228001526 |
Provider Name | Samara Acosta |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205553112 PECOS PAC ID: 6305217092 Enrollment ID: I20230117000310 |
Provider Name | Hayden Nelms |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1932651270 PECOS PAC ID: 1658714605 Enrollment ID: I20240207001786 |
Irwin Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 S Cherry St, Ocilla, GA 31774 Phone: 229-468-5020 Fax: 229-468-5024 | |
Irwin Specialty Centers Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 N Irwin Ave, Ocilla, GA 31774 Phone: 229-468-3800 | |
Irwin Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 361 Cargile Rd, Ocilla, GA 31774 Phone: 229-468-3975 | |
South Central Family Health Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 607c N Irwin Ave, Ocilla, GA 31774 Phone: 229-468-5020 Fax: 229-468-5024 | |
Irwin Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 361 Cargile Rd, Ocilla, GA 31774 Phone: 229-468-3975 | |
Kids Health-ic Schools Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 149 Chieftain Cir, Ocilla, GA 31774 Phone: 229-468-9166 Fax: 229-468-9188 | |
Irwin County Hospital Authority Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 710 N Irwin Ave, Ocilla, GA 31774 Phone: 229-468-3800 |