SOUTHWELL AMBULATORY INC
NPI 1164069472
Internal Medicine - Gastroenterology in Valdosta, GA
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
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southwell Ambulatory Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
16Medicare enrollment records show 16 clinicians reassign Medicare billing to Southwell Ambulatory Inc, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 13 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (16)
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 11D0265545
Southwell Ambulatory, Inc Dba Southwell Internal Medicine · Valdosta, 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 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.
Is Southwell Ambulatory Inc enrolled in Medicare?
Yes. Southwell Ambulatory Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southwell Ambulatory Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 16 clinicians in 5 Medicare specialties reassign their Medicare billing to Southwell Ambulatory Inc. 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. The largest specialties are Certified Nurse Midwife (CNM) (4), Nurse Practitioner (4) and Gastroenterology (3). Of these, 2 practice at this address and 13 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 11 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.
# Southwell Ambulatory Inc · NPI 1164069472
Gastroenterology organization in Valdosta, Georgia. Organization record, active in the CMS NPPES registry since December 5, 2019.
## Identity
- **NPI:** 1164069472 (Entity type: Organization)
- **Enumerated:** December 5, 2019
- **Primary specialty:** Internal Medicine - Gastroenterology · taxonomy 207RG0100X
- **Also known as:** Southwell Gastroenterology (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Troy Brooks, SVP/CFO
## Practice location
- **Address:** 2922 N OAK ST STE C, Valdosta, GA 31602-1885
- **Phone:** (229) 244-1570 · **Fax:** (229) 299-4291
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 16 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Certified Nurse Midwife (CNM) (4), Nurse Practitioner (4), Gastroenterology (3); 2 practice at this address and 13 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 27, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1164069472) · Data from the CMS NPPES public registry.