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AUGUSTA ENT PC
NPI 1043377005
Specialist in Thomson, GA

Active since January 02, 2007CLIA Certified · 3 labs
315 FLUKER ST, THOMSON, GA 30824(706) 868-5676(706) 722-2824 Get Directions Write a Review

NPPES record last updated: May 14, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Augusta Ent Pc NPPES

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

AUGUSTA ENT PC (NPI 1043377005) is a healthcare organization registered as a specialist in Thomson, Georgia and active in the NPI registry since January 2007. The organization holds 3 active CLIA laboratory certificates and lists Jammie Lee Sparks, Billing Supervisor, as its authorized official.

NPPES Registry Identity

NPI1043377005
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameAUGUSTA ENT PC
Location Address315 FLUKER STThomson, GA 30824-2108
Mailing Address340 N Belair RdEvans, GA 30809-3000 · (706) 868-5676 · Fax (706) 722-2824
Phone(706) 868-5676
Fax(706) 722-2824
Organization SubpartNo
Authorized OfficialJammie Lee SparksBilling Supervisor · (706) 868-5676
Enumeration DateJanuary 2, 2007
Last NPPES UpdateMay 14, 2008
✔ NPI 1043377005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
315 FLUKER ST, Thomson, GA 30824
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Other Identifiers 1

Medicare ID-Type UnspecifiedGRP1536GA

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Augusta Ent Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

22

Medicare enrollment records show 22 clinicians reassign Medicare billing to Augusta Ent PC, which bills Medicare for the services they deliver. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 4

Otolaryngology14
Nurse Practitioner4
Allergy/Immunology2
Qualified Audiologist2

Nearest to this location (20)

See all 22
Sarah New, NP
Nurse Practitioner
NPI 1598355174
4039 GATEWAY BLVD
Grovetown, GA 30813
(706) 922-1600
✔ PECOS✔ Accepts Medicare17 mi
James Kimbrough, MD
Otolaryngology
NPI 1568585776
340 NORTH BELAIR ROAD
Evans, GA 30809
(706) 868-5676
✔ PECOS✔ Accepts Medicare21 mi
Christopher Ayers, M.D.
Otolaryngology
NPI 1952697633
340 N BELAIR RD
Evans, GA 30809
(706) 868-5676
✔ PECOS✔ Accepts Medicare22 mi
William Barfield, MD
Otolaryngology
NPI 1386618155
340 N BELAIR RD
Evans, GA 30809
(706) 868-5676
✔ PECOS✔ Accepts Medicare22 mi
Robert Deal, MD
Otolaryngology
NPI 1376654269
340 N BELAIR RD
Evans, GA 30809
(706) 868-5676
✔ PECOS✔ Accepts Medicare22 mi
Ralph Owen, MD
Otolaryngology
NPI 1134195407
340 N BELAIR RD
Evans, GA 30809
(706) 868-5676
✔ PECOS✔ Accepts Medicare22 mi
Edward Porubsky, MD
Otolaryngology
NPI 1043286313
340 N BELAIR RD
Evans, GA 30809
(706) 868-5676
✔ PECOS✔ Accepts Medicare22 mi
Jonathan Rutledge, M.D.
Otolaryngology
NPI 1023242195
340 N BELAIR RD
Evans, GA 30809
(706) 868-5676
✔ PECOS✔ Accepts Medicare22 mi
Christopher Vickery, MD
Otolaryngology
NPI 1952377228
340 N BELAIR RD
Evans, GA 30809
(706) 868-5676
✔ PECOS✔ Accepts Medicare22 mi
Alan Whitehouse, MD
Otolaryngology
NPI 1588637227
340 N BELAIR RD
Evans, GA 30809
(706) 868-5676
✔ PECOS✔ Accepts Medicare22 mi
Jonathan Lindman, MD
Otolaryngology
NPI 1740242692
340 N BELAIR RD
Evans, GA 30809
(706) 868-5676
✔ PECOS✔ Accepts Medicare22 mi
Lauren White, M.D.
Otolaryngology
NPI 1528354669
340 N BELAIR RD
Evans, GA 30809
(706) 721-4307
✔ PECOS✔ Accepts Medicare22 mi
Scott Walton, M.D.
Otolaryngology
NPI 1073970091
300 E HOSPITAL RD
Ft. Gordon, GA 30905
(801) 400-5439
✔ PECOS✔ Accepts Medicare22 mi
Vanitcha Pintavorn, MD
Allergy/Immunology
NPI 1215931555
418 TOWN PARK BLVD SUITE 1A
Evans, GA 30809
(706) 650-1662
✔ PECOS✔ Accepts Medicare22 mi
Gena Bonitatibus, M.D.
Allergy/Immunology
NPI 1184621310
4350 TOWNE CENTRE DR STE 1500
Evans, GA 30809
(706) 421-1700
✔ PECOS✔ Accepts Medicare22 mi
Meredith Carr, APRN
Nurse Practitioner
NPI 1720634397
3121 PEACH ORCHARD RD STE 103
Augusta, GA 30906
(706) 792-5057
✔ PECOS✔ Accepts Medicare28 mi
Alishia Mccoullough, FNP-C, FNP-BC
Nurse Practitioner
NPI 1982197570
1350 WALTON WAY
Augusta, GA 30901
(706) 722-9011
✔ PECOS✔ Accepts Medicare30 mi
Bari Levens, AUD, CCC-A
Qualified Audiologist
NPI 1356450209
1303 DANTIGNAC STREET SUITE 1000
Augusta, GA 30901
(706) 868-5676
✔ Accepts Medicare30 mi
Emily Cyr, AUD
Qualified Audiologist
NPI 1487107660
74 PHYSICIAN DR
Aiken, SC 29801
(706) 868-5676
✔ Accepts Medicare44 mi
Lincoln Lippincott, MD
Otolaryngology
NPI 1154320661
120 S ZETTEROWER AVE
Statesboro, GA 30458
(912) 681-7368
✔ PECOS✔ Accepts Medicare82 mi
See all 22 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 3

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 11D1029442

Augusta Ent · Evans, GA
Active · expires Apr 11, 2027
CLIA Number11D1029442
Laboratory TypePhysician Office
Certificate Effective DateApril 12, 2025
Certificate Expiration DateApril 11, 2027
Laboratory DirectorEdward Porubsky
Laboratory Phone(706) 868-5676
Laboratory LocationAugusta Ent340 North Belair Road, Evans, GA 30809
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2324641

Augusta Ent PC · Statesboro, GA
Active · expires May 28, 2027
CLIA Number11D2324641
Laboratory TypePhysician Office
Certificate Effective DateMay 29, 2025
Certificate Expiration DateMay 28, 2027
Laboratory DirectorLincoln Lippincott
Laboratory Phone(706) 868-5676
Laboratory LocationAugusta Ent PC1301 Statesboro Place Circle, Statesboro, GA 30458
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2029438

Augusta Ent · Augusta, GA
Active · expires Feb 28, 2027
CLIA Number11D2029438
Laboratory TypePhysician Office
Certificate Effective DateMarch 1, 2025
Certificate Expiration DateFebruary 28, 2027
Laboratory DirectorJames F. Kimbrough
Laboratory Phone(706) 868-5676
Laboratory LocationAugusta Ent720 St Sebastian Way, Suite 201, Augusta, GA 30901
CLIA data matches this NPI record on: 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 Augusta Ent PC's NPI number?

The NPI number for Augusta Ent PC is 1043377005. It was assigned to this organization in the NPPES registry on January 2, 2007.

Where is Augusta Ent PC located?

Augusta Ent PC is located at 315 Fluker St, Thomson, GA 30824. The listed phone number is (706) 868-5676.

What is Augusta Ent PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Augusta Ent PC enrolled in Medicare?

Yes. Augusta Ent PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Augusta Ent PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 22 clinicians in 4 Medicare specialties reassign their Medicare billing to Augusta Ent PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Otolaryngology (14), Nurse Practitioner (4) and Allergy/Immunology (2). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Augusta Ent PC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Augusta Ent PC was last updated on May 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.