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MR. GEORGE WILLIAM DURRELL IV PA-C
NPI 1053144238
Physician Assistant - Surgical in Statesboro, GA

Active since August 22, 2024PECOS EnrolledAccepts Medicare Assignment
1497 FAIR RD STE 200, STATESBORO, GA 30458(912) 871-7100(912) 871-7110 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 4, 2025, Nov 7, 2024, Aug 22, 2024 (3 updates tracked since 2024).

About Mr. George William Durrell Iv Pa-c NPPES

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

MR. GEORGE WILLIAM DURRELL IV PA-C (NPI 1053144238) is an individual surgical provider in Statesboro, Georgia, licensed in Georgia (12628) and active in the NPI registry since August 2024. He is enrolled in Medicare PECOS, is affiliated with East Georgia Regional Medical Center, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1053144238
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. GEORGE WILLIAM DURRELL IVCredential: PA-C
Location Address1497 FAIR RD STE 200Statesboro, GA 30458-0824
Mailing AddressPo Box 689022Franklin, TN 37068-9022 · (912) 871-7100 · Fax (912) 871-7110
Phone(912) 871-7100
Fax(912) 871-7110
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateAugust 22, 2024
Last NPPES UpdateNovember 4, 20253 updates tracked since enumeration
NPPES CertifiedNovember 4, 2025
✔ NPI 1053144238 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in GA · 12628
Also ListedPhysician AssistantTaxonomy 363A00000X · License 12628 (GA)
1497 FAIR RD STE 200, Statesboro, GA 30458
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. George William Durrell Iv Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103352018
PECOS Enrollment IDI20241216000140
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

East Georgia Regional Medical Center

Acute Care Hospitals · Statesboro, GA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number110075
Location1499 Fair RoadStatesboro, GA 30458 · Bulloch County
Emergency services

Other Providers at the Same Location NPPES 3

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

MARY JACQUELINE CHARLIER RDN
Dietitian, Registered
1497 FAIR RD STE 200
STATESBORO, GA 30458
Bulloch County (912) 871-7100
RICHARD TYLER COWART MD
Surgery
1497 FAIR RD STE 200
STATESBORO, GA 30458
Bulloch County (912) 871-7100
KENNETH BRIAN WALTON MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1497 FAIR RD STE 200
STATESBORO, GA 30458
Bulloch County (912) 871-7100

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 George Durrell's NPI number?

The NPI number for George Durrell is 1053144238. It was assigned to this individual provider in the NPPES registry on August 22, 2024.

Where is George Durrell located?

George Durrell practices at 1497 Fair Rd Ste 200, Statesboro, GA 30458. The listed phone number is (912) 871-7100.

What is George Durrell's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is George Durrell enrolled in Medicare?

Yes. George Durrell is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is George Durrell affiliated with any hospitals?

According to CMS data, George Durrell is affiliated with East Georgia Regional Medical Center.

When was this NPI record last updated?

The NPPES record for George Durrell was last updated on November 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.