C. WAYNE DODGEN, MD, PC
NPI 1104022425
Family Medicine in Thomaston, GA
About C. Wayne Dodgen, Md, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
C. WAYNE DODGEN, MD, PC (NPI 1104022425) is a healthcare organization registered as a family medicine in Thomaston, Georgia and active in the NPI registry since June 2007. The organization holds a CLIA Waiver certificate valid through July 5, 2028 and lists Charles Wayne Dodgen, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
C. Wayne Dodgen, Md, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to C. Wayne Dodgen, MD, PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 11D0948247
C Wayne Dodgen MD · Thomaston, GAFrequently 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 C. Wayne Dodgen, MD, PC's NPI number?
The NPI number for C. Wayne Dodgen, MD, PC is 1104022425. It was assigned to this organization in the NPPES registry on June 24, 2007.
Where is C. Wayne Dodgen, MD, PC located?
C. Wayne Dodgen, MD, PC is located at 107 Jackson Ave Suite A, Thomaston, GA 30286. The listed phone number is (706) 647-8101.
What is C. Wayne Dodgen, MD, PC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is C. Wayne Dodgen, MD, PC enrolled in Medicare?
Yes. C. Wayne Dodgen, MD, PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through C. Wayne Dodgen, MD, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to C. Wayne Dodgen, MD, PC, in Family Practice 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does C. Wayne Dodgen, MD, PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D0948247) is associated with this NPI, valid through July 5, 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 C. Wayne Dodgen, MD, PC was last updated on August 22, 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.
# C. Wayne Dodgen, Md, Pc · NPI 1104022425
Family Medicine organization in Thomaston, Georgia. Organization record, active in the CMS NPPES registry since June 24, 2007.
## Identity
- **NPI:** 1104022425 (Entity type: Organization)
- **Enumerated:** June 24, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Charles Dodgen, CEO
## Practice location
- **Address:** 107 JACKSON AVE, SUITE A, Thomaston, GA 30286-3433
- **Phone:** (706) 647-8101 · **Fax:** (706) 647-8543
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Nurse Practitioner (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
- **Other identifiers:** Other 11DO948247 (GA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104022425) · Data from the CMS NPPES public registry.