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SOUTHWELL AMBULATORY INC
NPI 1164069472
Internal Medicine - Gastroenterology in Valdosta, GA

Active since December 05, 2019CLIA 11D0265545 · Waiver
2922 N OAK ST STE C, VALDOSTA, GA 31602(229) 244-1570(229) 299-4291 Get Directions Write a Review

NPPES record last updated: October 27, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 18, 2022, Oct 14, 2021, May 27, 2020 and 2 more (5 updates tracked since 2019).

About Southwell Ambulatory Inc NPPES

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

SOUTHWELL AMBULATORY INC (NPI 1164069472), doing business as Southwell Gastroenterology, is a healthcare organization registered as a gastroenterology in Valdosta, Georgia and active in the NPI registry since December 2019. The organization holds a CLIA Waiver certificate valid through January 31, 2027, maintains a secondary practice location in Valdosta, and lists Troy Brooks, Svp/cfo, as its authorized official.

NPPES Registry Identity

NPI1164069472
Entity TypeOrganization
Primary Taxonomy207RG0100X
Legal Business NameSOUTHWELL AMBULATORY INC
Location Address2922 N OAK ST STE CValdosta, GA 31602-1885
Mailing AddressPo Box 2650Tifton, GA 31793-2650 · (229) 353-3422 · Fax (229) 353-6060
Phone(229) 244-1570
Fax(229) 299-4291
Organization SubpartNo
Authorized OfficialTroy BrooksSvp/cfo · (229) 353-3397
Enumeration DateDecember 5, 2019
Last NPPES UpdateOctober 27, 20255 updates tracked since enumeration
NPPES CertifiedOctober 27, 2025
✔ NPI 1164069472 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
2922 N OAK ST STE C, Valdosta, GA 31602
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Other Names 1

Doing Business AsSouthwell Gastroenterology

Secondary Practice Location 1

Location 13790 Old US 41 N Ste BValdosta, GA 31602-6866 · Phone (229) 262-6800

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

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 11D0265545

Southwell Ambulatory, Inc Dba Southwell Internal Medicine · Valdosta, GA
Active · expires Jan 31, 2027
CLIA Number11D0265545
Laboratory TypePhysician Office
Certificate Effective DateFebruary 1, 2025
Certificate Expiration DateJanuary 31, 2027
Laboratory DirectorLynn S. Lee
Laboratory Phone(229) 353-7535
Laboratory LocationSouthwell Ambulatory, Inc Dba Southwell Internal Medicine3014 North Patterson St, Valdosta, GA 31602
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NANCY CAROLINE ROE FNP-C
Nurse Practitioner (Family)
2922 N OAK ST STE C
VALDOSTA, GA 31602
Lowndes County (229) 244-1570
SOUTHWELL AMBULATORY INC
Family Medicine
2922 N OAK ST STE C
VALDOSTA, GA 31602
Lowndes County (229) 262-6819
KENNETH LINDSEY KISER APRN
Nurse Practitioner (Primary Care)
2922 N OAK ST STE C
VALDOSTA, GA 31602
Lowndes County (229) 262-6819

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 Southwell Ambulatory Inc's NPI number?

The NPI number for Southwell Ambulatory Inc is 1164069472. It was assigned to this organization in the NPPES registry on December 5, 2019. The provider is doing business as Southwell Gastroenterology.

Where is Southwell Ambulatory Inc located?

Southwell Ambulatory Inc is located at 2922 N Oak St Ste C, Valdosta, GA 31602. The listed phone number is (229) 244-1570.

What is Southwell Ambulatory Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Does Southwell Ambulatory Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0265545) is associated with this NPI, valid through January 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Southwell Ambulatory Inc accept?

Health plans from Alliant Health Plans, Inc. list Southwell Ambulatory Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southwell Ambulatory Inc was last updated on October 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.