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SOUTH CENTRAL PRIMARY CARE CENTER, INC
NPI 1063840296
Clinic/Center - Federally Qualified Health Center (FQHC) in Douglas, GA

Active since October 25, 2013CLIA Certified · 2 labs
303 SHIRLEY AVE, STE B, DOUGLAS, GA 31533(912) 384-2474(912) 384-4995 Get Directions Write a Review

NPPES record last updated: April 3, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 3, 2025, Oct 8, 2021, Sep 19, 2016 (3 updates tracked since 2016).

About South Central Primary Care Center, Inc NPPES

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

SOUTH CENTRAL PRIMARY CARE CENTER, INC (NPI 1063840296), doing business as Kids Health, is a healthcare organization registered as a federally qualified health center (fqhc) in Douglas, Georgia and active in the NPI registry since October 2013. The organization holds 2 active CLIA laboratory certificates and lists Robert B Tucker, Ceo, as its authorized official.

NPPES Registry Identity

NPI1063840296
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameSOUTH CENTRAL PRIMARY CARE CENTER, INC
Location Address303 SHIRLEY AVE, STE BDouglas, GA 31533
Mailing Address204 E 4th St, P O Box 749Ocilla, GA 31774-1539 · (229) 468-9166 · Fax (229) 468-9188
Phone(912) 384-2474
Fax(912) 384-4995
Organization SubpartNo
Authorized OfficialRobert B TuckerCeo · (229) 468-9166
Enumeration DateOctober 25, 2013
Last NPPES UpdateApril 3, 20253 updates tracked since enumeration
NPPES CertifiedApril 3, 2025
✔ NPI 1063840296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
303 SHIRLEY AVE, Douglas, GA 31533
Open in Google Maps ↗

Other Names 2

Doing Business AsKids Health
Doing Business AsSouth Central Primary Care

Other Identifiers 1

Medicaid003140047AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

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 11D2303782

South Central Primary Care Ashley Street · Valdosta, GA
Active · expires Apr 30, 2028
CLIA Number11D2303782
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateMay 1, 2026
Certificate Expiration DateApril 30, 2028
Laboratory DirectorClarence Hunter
Laboratory Phone(229) 468-9166
Laboratory LocationSouth Central Primary Care Ashley Street2301 N Ashley Street, Valdosta, GA 31602
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2232380

South Central Primary Care Center Shirley Avenue · Douglas, GA
Active · expires Aug 11, 2027
CLIA Number11D2232380
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateAugust 12, 2025
Certificate Expiration DateAugust 11, 2027
Laboratory DirectorClarence Hunter
Laboratory Phone(912) 384-2474
Laboratory LocationSouth Central Primary Care Center Shirley Avenue303 B Shirley Avenue, Douglas, GA 31533
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 South Central Primary Care Center, Inc's NPI number?

The NPI number for South Central Primary Care Center, Inc is 1063840296. It was assigned to this organization in the NPPES registry on October 25, 2013. The provider is doing business as Kids Health and South Central Primary Care.

Where is South Central Primary Care Center, Inc located?

South Central Primary Care Center, Inc is located at 303 Shirley Ave Ste B, Douglas, GA 31533. The listed phone number is (912) 384-2474.

What is South Central Primary Care Center, Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does South Central Primary Care Center, Inc hold CLIA laboratory certificates?

Yes. 2 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.

What insurance does South Central Primary Care Center, Inc accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list South Central Primary Care Center, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for South Central Primary Care Center, Inc was last updated on April 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.