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RESTOR METABOLIX OF BLACKSHEAR
NPI 1174287379
Internal Medicine - Endocrinology, Diabetes & Metabolism in Blackshear, GA

Active since October 25, 2021CLIA 11D2246645 · Waiver
3345 US HIGHWAY 84 STE 102, BLACKSHEAR, GA 31516(912) 208-3581 Get Directions Write a Review

NPPES record last updated: November 11, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Restor Metabolix Of Blackshear NPPES

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

RESTOR METABOLIX OF BLACKSHEAR (NPI 1174287379) is a healthcare organization registered as an endocrinology, diabetes & metabolism in Blackshear, Georgia and active in the NPI registry since October 2021. The organization holds a CLIA Waiver certificate valid through December 27, 2027 and lists Randall Crawford, Manager, as its authorized official.

NPPES Registry Identity

NPI1174287379
Entity TypeOrganization
Primary Taxonomy207RE0101X
Legal Business NameRMX BLACKSHEAR LLC
Location Address3345 US HIGHWAY 84 STE 102Blackshear, GA 31516-2160
Mailing Address3345 Us Highway 84 Ste 102Blackshear, GA 31516-2160 · (912) 208-3581
Phone(912) 208-3581
Organization SubpartNo
Authorized OfficialRandall CrawfordManager · (912) 208-3581
Enumeration DateOctober 25, 2021
Last NPPES UpdateNovember 11, 2022
NPPES CertifiedNovember 11, 2022
✔ NPI 1174287379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedClinic/CenterTaxonomy 261Q00000X
3345 US HIGHWAY 84 STE 102, Blackshear, GA 31516
Open in Google Maps ↗

Other Names 1

Doing Business AsRestor Metabolix Of Blackshear

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Restor Metabolix Of Blackshear is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateGeorgiaEnrollment IDO20211203000832Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Restor Metabolix Of Blackshear, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (7)

Stephanie Chadwick, FNP
Nurse Practitioner
NPI 1376135798
3345 US HIGHWAY 84 STE 102
Blackshear, GA 31516
(912) 228-1358
✔ PECOS✔ Accepts MedicareSame address
Susan Deen, NP
Nurse Practitioner
NPI 1497536866
3345 US HIGHWAY 84 STE 102
Blackshear, GA 31516
(912) 208-3581
✔ PECOSSame address
Errol Graham, M.D.
Internal Medicine
NPI 1821081860
105 E TOLLISON ST STE C
Baxley, GA 31513
(912) 367-4122
✔ PECOS✔ Accepts Medicare33 mi
Michael Moss, MD
Internal Medicine
NPI 1851554935
654 S MAIN ST
Baxley, GA 31513
(912) 367-4122
✔ PECOS✔ Accepts Medicare34 mi
Randall Crawford Jr
Nurse Practitioner
NPI 1740678739
101 HARRIS INDUSTRIAL BLVD SUITE A
Vidalia, GA 30474
(912) 535-3500
✔ PECOS✔ Accepts Medicare63 mi
Cynthia Holton, NP-C
Nurse Practitioner
NPI 1912252792
1811 MANNING DR
Vidalia, GA 30474
(912) 733-4555
✔ PECOS✔ Accepts Medicare63 mi
Rachel Peterson Moss, NP-C
Nurse Practitioner
NPI 1811302029
530 S HOUSTON LAKE RD
Warner Robins, GA 31088
(478) 666-3377
✔ PECOS✔ Accepts Medicare123 mi

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 11D2246645

Restor Metabolix Of Blackshear · Blackshear, GA
Active · expires Dec 27, 2027
CLIA Number11D2246645
Laboratory TypePhysician Office
Certificate Effective DateDecember 28, 2025
Certificate Expiration DateDecember 27, 2027
Laboratory DirectorCourtney L. Hayes
Laboratory Phone(912) 208-3581
Laboratory LocationRestor Metabolix Of Blackshear3345 Us Highway 84 West Unit 102, Blackshear, GA 31516
CLIA data matches this NPI record on: 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 Rmx Blackshear LLC's NPI number?

The NPI number for Rmx Blackshear LLC is 1174287379. It was assigned to this organization in the NPPES registry on October 25, 2021. The provider is doing business as Restor Metabolix Of Blackshear.

Where is Rmx Blackshear LLC located?

Rmx Blackshear LLC is located at 3345 Us Highway 84 Ste 102, Blackshear, GA 31516. The listed phone number is (912) 208-3581.

What is Rmx Blackshear LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Rmx Blackshear LLC enrolled in Medicare?

Yes. Rmx Blackshear LLC is registered in the Medicare PECOS enrollment system.

When is Rmx Blackshear LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Rmx Blackshear LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 2 Medicare specialties reassign their Medicare billing to Rmx Blackshear 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. The largest specialties are Nurse Practitioner (5) and Internal Medicine (2). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Rmx Blackshear LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2246645) is associated with this NPI, valid through December 27, 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 Rmx Blackshear LLC was last updated on November 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.