ALTAMAHA PRIMARY CARE, LLC
NPI 1093472896
Nurse Practitioner - Primary Care in Jesup, GA
About Altamaha Primary Care, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALTAMAHA PRIMARY CARE, LLC (NPI 1093472896) is a healthcare organization registered as a primary care in Jesup, Georgia and active in the NPI registry since November 2021. The organization lists Kimberly Kirk, Owner/president, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Altamaha Primary Care, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Altamaha Primary Care, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Altamaha Primary Care, LLC's NPI number?
The NPI number for Altamaha Primary Care, LLC is 1093472896. It was assigned to this organization in the NPPES registry on November 29, 2021.
Where is Altamaha Primary Care, LLC located?
Altamaha Primary Care, LLC is located at 248 NE Broad St, Jesup, GA 31546. The listed phone number is (912) 559-2696.
What is Altamaha Primary Care, LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Altamaha Primary Care, LLC enrolled in Medicare?
Yes. Altamaha Primary Care, LLC is registered in the Medicare PECOS enrollment system.
When is Altamaha Primary Care, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Altamaha Primary Care, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Altamaha Primary Care, LLC. 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.
When was this NPI record last updated?
The NPPES record for Altamaha Primary Care, LLC was last updated on November 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Altamaha Primary Care, Llc · NPI 1093472896
Primary Care organization in Jesup, Georgia. Organization record, active in the CMS NPPES registry since November 29, 2021.
## Identity
- **NPI:** 1093472896 (Entity type: Organization)
- **Enumerated:** November 29, 2021
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **Organization subpart:** No
- **Authorized official:** Kimberly Kirk, OWNER/PRESIDENT
## Practice location
- **Address:** 248 NE BROAD ST, Jesup, GA 31546-4371
- **Phone:** (912) 559-2696 · **Fax:** (912) 559-2420
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Georgia, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 29, 2021
- **Other identifiers:** Medicaid G07348B (GA)
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Source: [NPI Profile](https://npiprofile.com/npi/1093472896) · Data from the CMS NPPES public registry.