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ALTAMAHA PRIMARY CARE, LLC
NPI 1093472896
Nurse Practitioner - Primary Care in Jesup, GA

Active since November 29, 2021
248 NE BROAD ST, JESUP, GA 31546(912) 559-2696(912) 559-2420 Get Directions Write a Review

NPPES record last updated: November 29, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1093472896
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameALTAMAHA PRIMARY CARE, LLC
Location Address248 NE BROAD STJesup, GA 31546-4371
Mailing Address248 Ne Broad StJesup, GA 31546-4371 · (912) 559-2696 · Fax (912) 559-2420
Phone(912) 559-2696
Fax(912) 559-2420
Organization SubpartNo
Authorized OfficialKimberly KirkOwner/president · (912) 559-2420
Enumeration DateNovember 29, 2021
NPPES CertifiedNovember 29, 2021
✔ NPI 1093472896 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
248 NE BROAD ST, Jesup, GA 31546
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Other Identifiers 1

MedicaidG07348BGA

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

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.

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.