EAST GEORGIA PEDIATRICS
NPI 1295999795
Specialist in Statesboro, GA

Active since July 14, 2008CLIA 11D1038200 · Waiver
715 NORTHSIDE DR E, SUITE 5 PMB 398, STATESBORO, GA 30458(912) 489-3325(912) 764-4977 Get Directions Write a Review

NPPES record last updated: July 14, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About East Georgia Pediatrics NPPES

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

EAST GEORGIA PEDIATRICS (NPI 1295999795) is a healthcare organization registered as a specialist in Statesboro, Georgia and active in the NPI registry since July 2008. The organization holds a CLIA Waiver certificate valid through March 13, 2027 and lists Michael Deal, Owner, as its authorized official.

NPPES Registry Identity

NPI1295999795
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameEAST GEORGIA PEDIATRICS
Location Address715 NORTHSIDE DR E, SUITE 5 PMB 398Statesboro, GA 30458-4712
Mailing Address127 N College StStatesboro, GA 30458-5387 · (912) 489-3325 · Fax (912) 764-4977
Fax(912) 764-4977
Organization SubpartNo
Authorized OfficialMichael DealOwner · (912) 489-3325
Enumeration DateJuly 14, 2008
NPI 1295999795 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.

715 NORTHSIDE DR E, Statesboro, GA 30458

Other Identifiers 3

Other10051619GA · Amerigroup
Other354428GA · Wellcare
Medicaid000372391GGA

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

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 11D1038200

East Georgia Pediatric PC · Statesboro, GA
Active · expires Mar 13, 2027
CLIA Number11D1038200
Laboratory TypePhysician Office
Certificate Effective DateMarch 14, 2025
Certificate Expiration DateMarch 13, 2027
Laboratory DirectorMichael C. Deal
Laboratory Phone(912) 489-3325
Laboratory LocationEast Georgia Pediatric PC450 Georgia Avenue, Suite A, Statesboro, GA 30458
CLIA data matches this NPI record on: Name Phone
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.

Dentist
715 NORTHSIDE DR E
STATESBORO, GA 30458
Pharmacist
715 NORTHSIDE DR E
STATESBORO, GA 30458

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 East Georgia Pediatrics's NPI number?

The NPI number for East Georgia Pediatrics is 1295999795. It was assigned to this organization in the NPPES registry on July 14, 2008.

Where is East Georgia Pediatrics located?

East Georgia Pediatrics is located at 715 Northside Dr E Suite 5 Pmb 398, Statesboro, GA 30458. The listed phone number is (912) 489-3325.

What is East Georgia Pediatrics's specialty?

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

Does East Georgia Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D1038200) is associated with this NPI, valid through March 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does East Georgia Pediatrics accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list East Georgia Pediatrics 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 East Georgia Pediatrics was last updated on July 14, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.