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BAINBRIDGE MEDICAL ASSOCIATES, PC
NPI 1174705495
Specialist in Bainbridge, GA

Active since November 28, 2007CLIA 11D1021574 · Waiver
1518 MILULI AVE, BAINBRIDGE, GA 39819(229) 248-8500(229) 248-8600 Get Directions Write a Review

NPPES record last updated: October 25, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Bainbridge Medical Associates, Pc NPPES

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

BAINBRIDGE MEDICAL ASSOCIATES, PC (NPI 1174705495) is a healthcare organization registered as a specialist in Bainbridge, Georgia and active in the NPI registry since November 2007. The organization holds a CLIA Waiver certificate valid through January 25, 2028 and lists Jon Mallory Mcrae, Physician, as its authorized official.

NPPES Registry Identity

NPI1174705495
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameBAINBRIDGE MEDICAL ASSOCIATES, PC
Location Address1518 MILULI AVEBainbridge, GA 39819-4866
Mailing Address1518 Miluli AveBainbridge, GA 39819-4866 · (229) 248-8500 · Fax (229) 248-8600
Phone(229) 248-8500
Fax(229) 248-8600
Organization SubpartNo
Authorized OfficialJon Mallory McraePhysician · (229) 248-8580
Enumeration DateNovember 28, 2007
Last NPPES UpdateOctober 25, 2012
✔ NPI 1174705495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1518 MILULI AVE, Bainbridge, GA 39819
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Other Identifiers 1

OtherGRP6258GA · Medicare

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

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 11D1021574

Bainbridge Medical Associates · Bainbridge, GA
Active · expires Jan 25, 2028
CLIA Number11D1021574
Laboratory TypePhysician Office
Certificate Effective DateJanuary 26, 2026
Certificate Expiration DateJanuary 25, 2028
Laboratory DirectorMallory Mcrae
Laboratory Phone(229) 298-8500
Laboratory LocationBainbridge Medical Associates1518 Miluli Ave, Bainbridge, GA 39819
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

JERRY DAVID PHILLIPS JR. M.D.
Family Medicine
1518 MILULI AVE
BAINBRIDGE, GA 39819
Decatur County (229) 248-8500
JON MALLORY MCRAE JR. M.D.
Internal Medicine
1518 MILULI AVE
BAINBRIDGE, GA 39819
Decatur County (229) 248-8500

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 Bainbridge Medical Associates, PC's NPI number?

The NPI number for Bainbridge Medical Associates, PC is 1174705495. It was assigned to this organization in the NPPES registry on November 28, 2007.

Where is Bainbridge Medical Associates, PC located?

Bainbridge Medical Associates, PC is located at 1518 Miluli Ave, Bainbridge, GA 39819. The listed phone number is (229) 248-8500.

What is Bainbridge Medical Associates, PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Bainbridge Medical Associates, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D1021574) is associated with this NPI, valid through January 25, 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 Bainbridge Medical Associates, PC was last updated on October 25, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.