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BREMEN FAMILY MEDICINE
NPI 1003023987
General Practice in Bremen, GA

Active since May 17, 2007CLIA 11D1067856 · Waiver
308 CARROLLTON ST, BREMEN, GA 30110(770) 537-1960(770) 537-1901 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Bremen Family Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BREMEN FAMILY MEDICINE (NPI 1003023987) is a healthcare organization registered as a general practice in Bremen, Georgia and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through April 26, 2027 and lists Regina L Holloway, Owner, as its authorized official.

NPPES Registry Identity

NPI1003023987
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameBREMEN FAMILY MEDICINE
Location Address308 CARROLLTON STBremen, GA 30110-2015
Mailing Address327 Old Bushmill RdBremen, GA 30110-3835 · (770) 537-1960 · Fax (770) 537-1901
Phone(770) 537-1960
Fax(770) 537-1901
Organization SubpartNo
Authorized OfficialRegina L HollowayOwner · (770) 537-1960
Enumeration DateMay 17, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1003023987 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in GA · 034852
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
308 CARROLLTON ST, Bremen, GA 30110
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Other Identifiers 1

Medicaid00478552HGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D1067856

Bremen Family Medicine · Bremen, GA
Active · expires Apr 26, 2027
CLIA Number11D1067856
Laboratory TypePhysician Office
Certificate Effective DateApril 27, 2025
Certificate Expiration DateApril 26, 2027
Laboratory DirectorRegina L. Holloway
Laboratory Phone(770) 537-1960
Laboratory LocationBremen Family Medicine308 Carrollton Street, Bremen, GA 30110
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bremen Family Medicine's NPI number?

The NPI number for Bremen Family Medicine is 1003023987. It was assigned to this organization in the NPPES registry on May 17, 2007.

Where is Bremen Family Medicine located?

Bremen Family Medicine is located at 308 Carrollton St, Bremen, GA 30110. The listed phone number is (770) 537-1960.

What is Bremen Family Medicine's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Bremen Family Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D1067856) is associated with this NPI, valid through April 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bremen Family Medicine was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.