COMMUNITY PRIMARY CARE OF GEORGIA LLC
NPI 1336492511
Family Medicine - Geriatric Medicine in Gray, GA
About Community Primary Care Of Georgia Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COMMUNITY PRIMARY CARE OF GEORGIA LLC (NPI 1336492511) is a healthcare organization registered as a geriatric medicine in Gray, Georgia and active in the NPI registry since October 2012. The organization maintains a secondary practice location in Acworth and lists Elize Joseph, Director Of Practice Management, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Community Primary Care Of Georgia Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
71Medicare enrollment records show 71 clinicians reassign Medicare billing to Community Primary Care Of Georgia LLC, which bills Medicare for the services they deliver. Of these, 19 practice at this address and 20 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 6
Nearest to this location (20)
See all 71Source: 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 Community Primary Care Of Georgia LLC's NPI number?
The NPI number for Community Primary Care Of Georgia LLC is 1336492511. It was assigned to this organization in the NPPES registry on October 25, 2012.
Where is Community Primary Care Of Georgia LLC located?
Community Primary Care Of Georgia LLC is located at 1005 Boulder Dr, Gray, GA 31032. The listed phone number is (478) 621-2100.
What is Community Primary Care Of Georgia LLC's specialty?
The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.
Is Community Primary Care Of Georgia LLC enrolled in Medicare?
Yes. Community Primary Care Of Georgia LLC is registered in the Medicare PECOS enrollment system.
When is Community Primary Care Of Georgia LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Community Primary Care Of Georgia LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 71 clinicians in 6 Medicare specialties reassign their Medicare billing to Community Primary Care Of Georgia 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. The largest specialties are Nurse Practitioner (50), Family Practice (9) and Internal Medicine (9). Of these, 19 practice at this address and 20 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Community Primary Care Of Georgia LLC was last updated on June 28, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Community Primary Care Of Georgia Llc · NPI 1336492511
Geriatric Medicine organization in Gray, Georgia. Organization record, active in the CMS NPPES registry since October 25, 2012.
## Identity
- **NPI:** 1336492511 (Entity type: Organization)
- **Enumerated:** October 25, 2012
- **Primary specialty:** Family Medicine - Geriatric Medicine · taxonomy 207QG0300X
- **Organization subpart:** No
- **Authorized official:** Elize Joseph, DIRECTOR OF PRACTICE MANAGEMENT
## Practice location
- **Address:** 1005 BOULDER DR, Gray, GA 31032-6141
- **Phone:** (478) 621-2100 · **Fax:** (478) 744-0481
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Georgia, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 71 clinicians in 6 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (50), Family Practice (9), Internal Medicine (9); 19 practice at this address and 20 within 10 miles; [full list](https://npiprofile.com/npi/1336492511/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 28, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1336492511) · Data from the CMS NPPES public registry.