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ONE SOURCE VASCULAR
NPI 1275123671
Clinic/Center - Medical Specialty in Waycross, GA

Active since January 20, 2021
1406 HABERSHAM DR, WAYCROSS, GA 31501(912) 490-9420 Get Directions Write a Review

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

Record update history: Jan 11, 2022, Apr 20, 2021, Jan 22, 2021 (3 updates tracked since 2021).

About One Source Vascular NPPES

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

ONE SOURCE VASCULAR (NPI 1275123671) is a healthcare organization registered as a medical specialty in Waycross, Georgia and active in the NPI registry since January 2021. The organization maintains 2 additional practice locations and lists David P Murphy, Manager, as its authorized official.

NPPES Registry Identity

NPI1275123671
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameONE SOURCE VASCULAR
Location Address1406 HABERSHAM DRWaycross, GA 31501-5306
Mailing Address501 W Oneida StWaycross, GA 31501-5337 · (912) 283-7596 · Fax (912) 283-1618
Phone(912) 490-9420
Organization SubpartYesParent: Bacon County Health Services, Inc
Authorized OfficialDavid P MurphyManager · (912) 283-6471
Enumeration DateJanuary 20, 2021
Last NPPES UpdateJanuary 11, 20223 updates tracked since enumeration
NPPES CertifiedJanuary 11, 2022
✔ NPI 1275123671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
1406 HABERSHAM DR, Waycross, GA 31501
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Secondary Practice Locations 2

Location 1204 E 15th StAlma, GA 31510-2908 · Phone (912) 632-2952
Location 2821 S Main StBaxley, GA 31513-0164 · Phone (912) 705-5483

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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)

One Source Vascular is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to One Source Vascular, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ronald Locke, MD
General Surgery
NPI 1528065406
127 BEN CASEY DR STE 106
Fort Mill, SC 29708
(803) 547-6800
✔ PECOS✔ Accepts Medicare275 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 One Source Vascular's NPI number?

The NPI number for One Source Vascular is 1275123671. It was assigned to this organization in the NPPES registry on January 20, 2021.

Where is One Source Vascular located?

One Source Vascular is located at 1406 Habersham Dr, Waycross, GA 31501. The listed phone number is (912) 490-9420.

What is One Source Vascular's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Is One Source Vascular enrolled in Medicare?

Yes. One Source Vascular is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through One Source Vascular?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Surgery) reassigns their Medicare billing to One Source Vascular. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does One Source Vascular accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list One Source Vascular 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 One Source Vascular was last updated on January 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.