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PREMIERCARE OMEGA
NPI 1073140927
Family Medicine in Omega, GA

Active since March 23, 2020CLIA 11D2188609 · Microscopy
130 MOORE ST, OMEGA, GA 31775(229) 528-6500(229) 528-3283 Get Directions Write a Review

NPPES record last updated: May 5, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 5, 2020, Mar 23, 2020 (2 updates tracked since 2020).

About Premiercare Omega NPPES

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

PREMIERCARE OMEGA (NPI 1073140927), doing business as Premiercare Omega Llc, is a healthcare organization registered as a family medicine in Omega, Georgia and active in the NPI registry since March 2020. The organization holds a CLIA Microscopy certificate valid through July 19, 2028 and lists Robert Clyde Bowman, President, as its authorized official.

NPPES Registry Identity

NPI1073140927
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePREMIERCARE OMEGA
Location Address130 MOORE STOmega, GA 31775-3075
Mailing Address130 Moore StOmega, GA 31775-3075 · (229) 528-6500 · Fax (229) 528-3283
Phone(229) 528-6500
Fax(229) 528-3283
Organization SubpartNo
Authorized OfficialRobert Clyde BowmanPresident · (229) 387-4802
Enumeration DateMarch 23, 2020
Last NPPES UpdateMay 5, 20202 updates tracked since enumeration
NPPES CertifiedMay 5, 2020
✔ NPI 1073140927 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
130 MOORE ST, Omega, GA 31775
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Other Names 1

Former Legal Business NamePremiercare Omega Llc

Other Identifiers 1

Other256884477Family Medicine

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)

Premiercare Omega is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Premiercare Omega, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (3)

Kathryn Thompson, NP-C
Nurse Practitioner
NPI 1316337090
2225 US HIGHWAY 41 N
Tifton, GA 31794
(229) 391-4100
✔ PECOS10 mi
Brandy Carr, NP
Nurse Practitioner
NPI 1427418474
2225 US HIGHWAY 41 N
Tifton, GA 31794
(229) 391-4100
✔ PECOS10 mi
Jonathan Tronolone, MD
Cardiovascular Disease (Cardiology)
NPI 1376626432
1499 KENNEDY RD STE C
Tifton, GA 31794
(229) 238-3034
✔ PECOS✔ Accepts Medicare10 mi

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

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 for Provider-Performed Microscopy Procedures (PPMP) 11D2188609

Premier Care Omega · Omega, GA
Active · expires Jul 19, 2028
CLIA Number11D2188609
Laboratory TypePhysician Office
Certificate Effective DateJuly 20, 2026
Certificate Expiration DateJuly 19, 2028
Laboratory DirectorRobert C. Bowman
Laboratory Phone(229) 528-6500
Laboratory LocationPremier Care Omega130 Moore Street, Omega, GA 31775
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform 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 Premiercare Omega's NPI number?

The NPI number for Premiercare Omega is 1073140927. It was assigned to this organization in the NPPES registry on March 23, 2020. The provider was formerly known as Premiercare Omega LLC.

Where is Premiercare Omega located?

Premiercare Omega is located at 130 Moore St, Omega, GA 31775. The listed phone number is (229) 528-6500.

What is Premiercare Omega's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Premiercare Omega enrolled in Medicare?

Yes. Premiercare Omega is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Premiercare Omega?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Premiercare Omega, in Cardiovascular Disease (Cardiology) and Nurse Practitioner. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Premiercare Omega hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 11D2188609) is associated with this NPI, valid through July 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premiercare Omega was last updated on May 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.