SERENITY GYNECOLOGY, LLC
NPI 1295360949
Obstetrics & Gynecology - Gynecology in Fayetteville, GA

Q: What is Serenity Gynecology, LLC's NPI number?

The NPI number for Serenity Gynecology, LLC is 1295360949. It was assigned to this organization in the NPPES registry on March 3, 2020. The provider was formerly known as Premier Women's Gyn, LLC.

Q: What is Serenity Gynecology, LLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecology, with taxonomy code 207VG0400X.

Active since March 03, 2020CLIA 11D2185143 · Waiver

300 GLYNN STREET SOUTH, FAYETTEVILLE, GA 30214(770) 629-2702(770) 909-5004 Get Directions Write a Review

NPPES record last updated: March 21, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Serenity Gynecology, Llc NPPES

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

SERENITY GYNECOLOGY, LLC (NPI 1295360949), doing business as Premier Women's Gyn, Llc, is a healthcare organization registered as a gynecology in Fayetteville, Georgia and active in the NPI registry since March 2020. The organization holds a CLIA Waiver certificate valid through May 28, 2028 and lists Tracey St. Julian, Physician Owner, as its authorized official.

NPPES Registry Identity

NPI1295360949

Entity TypeOrganization

Primary Taxonomy207VG0400X

Legal Business NameSERENITY GYNECOLOGY, LLC

Location Address300 GLYNN STREET SOUTHFayetteville, GA 30214

Mailing Address300 Glynn Street SouthFayetteville, GA 30214 · (770) 629-2702 · Fax (770) 909-5004

Phone(770) 629-2702

Fax(770) 909-5004

Organization SubpartNo

Authorized OfficialTracey St. JulianPhysician Owner · (770) 629-2702

Enumeration DateMarch 3, 2020

Last NPPES UpdateMarch 21, 2024

NPPES CertifiedMarch 3, 2020

✔ NPI 1295360949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207VG0400X

Definition

A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee

300 GLYNN STREET SOUTH, Fayetteville, GA 30214

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Other Names 1

Former Legal Business NamePremier Women's Gyn, Llc

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 Ambetter Health.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)

Serenity Gynecology, Llc 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 Serenity Gynecology, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tracey St Julian, MD

Obstetrics/Gynecology

NPI 1306901467

300 GLYNN STREET SOUTH
Fayetteville, GA 30214

(770) 629-2702

✔ PECOS✔ Accepts MedicareSame address

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 11D2185143

Serenity Gynecology, LLC · Fayetteville, GA

Active · expires May 28, 2028

CLIA Number11D2185143

Laboratory TypePhysician Office

Certificate Effective DateMay 29, 2026

Certificate Expiration DateMay 28, 2028

Laboratory DirectorTracey L. St Julian

Laboratory Phone(770) 629-2702

Laboratory LocationSerenity Gynecology, LLC300 Glynn Street South, Fayetteville, GA 30214

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 Serenity Gynecology, LLC's NPI number?

The NPI number for Serenity Gynecology, LLC is 1295360949. It was assigned to this organization in the NPPES registry on March 3, 2020. The provider was formerly known as Premier Women's Gyn, LLC.

Where is Serenity Gynecology, LLC located?

Serenity Gynecology, LLC is located at 300 Glynn Street South, Fayetteville, GA 30214. The listed phone number is (770) 629-2702.

What is Serenity Gynecology, LLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecology, with taxonomy code 207VG0400X.

Is Serenity Gynecology, LLC enrolled in Medicare?

Yes. Serenity Gynecology, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Serenity Gynecology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Obstetrics/Gynecology) reassigns their Medicare billing to Serenity Gynecology, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Serenity Gynecology, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2185143) is associated with this NPI, valid through May 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Serenity Gynecology, LLC accept?

Health plans from Ambetter Health list Serenity Gynecology, LLC 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 Serenity Gynecology, LLC was last updated on March 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.