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STATESBORO CARDIOLOGY, PC
NPI 1205840105
Internal Medicine - Cardiovascular Disease in Statesboro, GA

Active since July 28, 2006CLIA 11D0939813 · Waiver
5 GRADY JOHNSON RD, STATESBORO, GA 30458(912) 489-6843(912) 489-6346 Get Directions Write a Review

NPPES record last updated: November 9, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 9, 2020, Oct 24, 2018 (2 updates tracked since 2018).

About Statesboro Cardiology, Pc NPPES

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

STATESBORO CARDIOLOGY, PC (NPI 1205840105) is a healthcare organization registered as a cardiovascular disease in Statesboro, Georgia and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through February 1, 2028, maintains 4 additional practice locations, and lists Stanley J Shin, Ceo, as its authorized official.

NPPES Registry Identity

NPI1205840105
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameSTATESBORO CARDIOLOGY, PC
Location Address5 GRADY JOHNSON RDStatesboro, GA 30458-6026
Mailing Address5 Grady Johnson RdStatesboro, GA 30458-6026 · (912) 489-6843 · Fax (912) 489-3125
Phone(912) 489-6843
Fax(912) 489-6346
Organization SubpartNo
Authorized OfficialStanley J ShinCeo · (912) 489-6246
Enumeration DateJuly 28, 2006
Last NPPES UpdateNovember 9, 20202 updates tracked since enumeration
NPPES CertifiedNovember 9, 2020
✔ NPI 1205840105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
5 GRADY JOHNSON RD, Statesboro, GA 30458
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Secondary Practice Locations 4

Location 1125C Victory DrSwainsboro, GA 30401-3234 · Phone (912) 489-6246 · Fax (912) 489-6346
Location 2400 Cedar St Ste 107Metter, GA 30439-3338 · Phone (912) 489-6246 · Fax (912) 489-6346
Location 3131 Memorial DrReidsville, GA 30453-4641 · Phone (912) 489-6246 · Fax (912) 489-6346
Location 4380 Sconyers StMetter, GA 30439-3261 · Phone (912) 489-6246 · Fax (912) 489-6346

Other Identifiers 1

Medicaid300033286AGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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)

Statesboro Cardiology, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Statesboro Cardiology, PC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 7 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Stephanie Pinard, FNP
Nurse Practitioner
NPI 1063062511
5 GRADY JOHNSON RD
Statesboro, GA 30458
(912) 489-6246
✔ PECOS✔ Accepts MedicareSame address
Abraham Lin, M.D.
Cardiovascular Disease (Cardiology)
NPI 1841388782
5 GRADY JOHNSON RD
Statesboro, GA 30458
(912) 489-6246
✔ PECOS✔ Accepts MedicareSame address
Sarah Lusted, NP
Nurse Practitioner
NPI 1962283424
5 GRADY JOHNSON RD
Statesboro, GA 30458
(912) 489-6246
✔ PECOS✔ Accepts MedicareSame address
David Nabert, M.D.
Cardiovascular Disease (Cardiology)
NPI 1174590863
5 GRADY JOHNSON RD
Statesboro, GA 30458
(912) 489-6246
✔ PECOS✔ Accepts MedicareSame address
Stanley Shin, MD
Cardiovascular Disease (Cardiology)
NPI 1801835194
5 GRADY JOHNSON RD
Statesboro, GA 30458
(912) 489-6246
✔ PECOS✔ Accepts MedicareSame address
Julio Schwarz, MD
Cardiovascular Disease (Cardiology)
NPI 1295997302
5 GRADY JOHNSON RD
Statesboro, GA 30458
(912) 489-6246
✔ PECOS✔ Accepts Medicare0.1 mi
Bailey Usher
Nurse Practitioner
NPI 1245020494
5 GRADY JOHNSON RD
Statesboro, GA 30458
(912) 489-6246
✔ PECOS✔ Accepts Medicare0.1 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 11D0939813

Statesboro Cardiology PC · Statesboro, GA
Active · expires Feb 1, 2028
CLIA Number11D0939813
Laboratory TypePhysician Office
Certificate Effective DateFebruary 2, 2026
Certificate Expiration DateFebruary 1, 2028
Laboratory DirectorStanley J. Shin
Laboratory Phone(912) 489-6246
Laboratory LocationStatesboro Cardiology PC5 Grady Johnson Road, Statesboro, GA 30458
CLIA data matches this NPI record on: Address 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 Statesboro Cardiology, PC's NPI number?

The NPI number for Statesboro Cardiology, PC is 1205840105. It was assigned to this organization in the NPPES registry on July 28, 2006.

Where is Statesboro Cardiology, PC located?

Statesboro Cardiology, PC is located at 5 Grady Johnson Rd, Statesboro, GA 30458. The listed phone number is (912) 489-6843.

What is Statesboro Cardiology, PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Statesboro Cardiology, PC enrolled in Medicare?

Yes. Statesboro Cardiology, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Statesboro Cardiology, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 2 Medicare specialties reassign their Medicare billing to Statesboro Cardiology, PC. 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 Cardiovascular Disease (Cardiology) (4) and Nurse Practitioner (3). Of these, 5 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Statesboro Cardiology, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0939813) is associated with this NPI, valid through February 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Statesboro Cardiology, PC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Statesboro Cardiology, PC 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 Statesboro Cardiology, PC was last updated on November 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.