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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: July 26, 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

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.

Other Providers at the Same Location NPPES 11

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

NEIGHBORHOOD IMPROVEMENT PROJECT INC.
Pharmacy (Community/Retail Pharmacy)
315 FLUKER ST
THOMSON, GA 30824
McDuffie County (706) 595-1090
MEGAN STUCKEY WILEY NP-C
Nurse Practitioner (Family)
315 FLUKER ST
THOMSON, GA 30824
McDuffie County (706) 595-1090
FAMILY CARE GROUP SOUTH, LLC
Family Medicine
315 FLUKER ST
THOMSON, GA 30824
McDuffie County (706) 595-1090
MALLORY MAYERS MONTES DNP, FNP-C
Nurse Practitioner (Family)
315 FLUKER ST
THOMSON, GA 30824
McDuffie County (706) 595-1090
NEIGHBORHOOD IMPROVEMENT PROJECT INC
Clinic/Center (Federally Qualified Health Center (FQHC))
315 FLUKER ST
THOMSON, GA 30824
McDuffie County (706) 790-4440
ROGER F. NELSON M.D.
Family Medicine
315 FLUKER ST
THOMSON, GA 30824
McDuffie County (706) 595-1090
DR. DARYL CARSON WILEY M.D.
Family Medicine
315 FLUKER ST
THOMSON, GA 30824
McDuffie County (706) 595-1090
DR. JAMES CHRISTOPHER SHEPPARD MD
Internal Medicine
315 FLUKER ST
THOMSON, GA 30824
McDuffie County (706) 595-1090

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.

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 with the weekly NPPES data releases published by CMS.