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SOUTHERN PODIATRY GROUP, PC
NPI 1013174457
Podiatrist - Foot & Ankle Surgery in Tifton, GA

Active since May 22, 2008CLIA 11D0265608 · Waiver
820 LOVE AVE, SUITE B, TIFTON, GA 31794(229) 382-5599 Get Directions Write a Review

NPPES record last updated: December 1, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southern Podiatry Group, Pc NPPES

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

SOUTHERN PODIATRY GROUP, PC (NPI 1013174457) is a healthcare organization registered as a foot & ankle surgery in Tifton, Georgia and active in the NPI registry since May 2008. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Avis Griffin, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1013174457
Entity TypeOrganization
Primary Taxonomy213ES0103X
Legal Business NameSOUTHERN PODIATRY GROUP, PC
Location Address820 LOVE AVE, SUITE BTifton, GA 31794-4071
Mailing Address2718 N Oak StValdosta, GA 31602-1781
Phone(229) 382-5599
Organization SubpartNo
Authorized OfficialAvis GriffinOffice Manager · (229) 242-3668
Enumeration DateMay 22, 2008
Last NPPES UpdateDecember 1, 2009
✔ NPI 1013174457 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
820 LOVE AVE, Tifton, GA 31794
Open in Google Maps ↗

Other Identifiers 4

Medicare NSC0266960001GA
Medicare PINCD9112GA
Medicaid300026567AGA
Medicare PINGRP81GA

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 11D0265608

Southern Podiatry Group PC · Valdosta, GA
Active · expires Aug 31, 2026
CLIA Number11D0265608
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorTimothy E. Pitts
Laboratory Phone(229) 242-3668
Laboratory LocationSouthern Podiatry Group PC2718 North Oak St, Valdosta, GA 31602
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SLEEP USA
Clinic/Center (Sleep Disorder Diagnostic)
820 LOVE AVE, SUITE E
TIFTON, GA 31794
Tift County (229) 387-0263
DR. HENRY CLAYTON DORMINEY JR. M.D.
Specialist
820 LOVE AVE, SUITE A
TIFTON, GA 31794
Tift County (229) 382-3720

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 Southern Podiatry Group, PC's NPI number?

The NPI number for Southern Podiatry Group, PC is 1013174457. It was assigned to this organization in the NPPES registry on May 22, 2008.

Where is Southern Podiatry Group, PC located?

Southern Podiatry Group, PC is located at 820 Love Ave Suite B, Tifton, GA 31794. The listed phone number is (229) 382-5599.

What is Southern Podiatry Group, PC's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Does Southern Podiatry Group, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0265608) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southern Podiatry Group, PC was last updated on December 1, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.