MAGNOLIA PRIMARY CARE LLC
NPI 1093537193
Clinic/Center - Primary Care in Springfield, GA

Active since October 29, 2024CLIA 11D2316268 · Waiver
807 S LAUREL ST STE B, SPRINGFIELD, GA 31329(912) 812-1005 Get Directions Write a Review

NPPES record last updated: October 29, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Magnolia Primary Care Llc NPPES

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

MAGNOLIA PRIMARY CARE LLC (NPI 1093537193) is a healthcare organization registered as a primary care in Springfield, Georgia and active in the NPI registry since October 2024. The organization holds a CLIA Waiver certificate valid through January 1, 2027 and lists Lauren Oglesby, Physician, as its authorized official.

NPPES Registry Identity

NPI1093537193
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameMAGNOLIA PRIMARY CARE LLC
Location Address807 S LAUREL ST STE BSpringfield, GA 31329-9273
Mailing AddressPo Box 180Springfield, GA 31329-0180
Organization SubpartNo
Authorized OfficialLauren OglesbyPhysician · (912) 655-5559
Enumeration DateOctober 29, 2024
NPPES CertifiedOctober 29, 2024
✔ NPI 1093537193 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
807 S LAUREL ST STE B, Springfield, GA 31329

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Magnolia Primary Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Magnolia Primary Care LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Internal Medicine
NPI 1336573179
807 S LAUREL ST STE B
Springfield, GA 31329
(912) 812-1005
✔ PECOS✔ Accepts MedicareSame address

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 of Waiver 11D2316268

Magnolia Primary Care · Springfield, GA
Active · expires Jan 1, 2027
CLIA Number11D2316268
Laboratory TypePhysician Office
Certificate Effective DateJanuary 2, 2025
Certificate Expiration DateJanuary 1, 2027
Laboratory DirectorLauren E. Oglesby
Laboratory Phone(912) 812-1005
Laboratory LocationMagnolia Primary Care807 S Laurel Street, Suite B, Springfield, GA 31329
CLIA data matches this NPI record on: Address 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 Magnolia Primary Care LLC's NPI number?

The NPI number for Magnolia Primary Care LLC is 1093537193. It was assigned to this organization in the NPPES registry on October 29, 2024.

Where is Magnolia Primary Care LLC located?

Magnolia Primary Care LLC is located at 807 S Laurel St Ste B, Springfield, GA 31329. The listed phone number is (912) 812-1005.

What is Magnolia Primary Care LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Magnolia Primary Care LLC enrolled in Medicare?

Yes. Magnolia Primary Care LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Magnolia Primary Care LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Magnolia 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.

Does Magnolia Primary Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2316268) is associated with this NPI, valid through January 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Magnolia Primary Care LLC was last updated on October 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.