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PROVIDENCE FAMILY MEDICINE CLINIC, INC
NPI 1346590148
Family Medicine in Lumpkin, GA

Active since September 19, 2012CLIA 11D2060225 · Waiver
1787 BROAD STREET, PROVIDENCE FAMILY MEDICINE CLINIC, INC, LUMPKIN, GA 31815(703) 593-6154 Get Directions Write a Review

NPPES record last updated: September 19, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Providence Family Medicine Clinic, Inc NPPES

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

PROVIDENCE FAMILY MEDICINE CLINIC, INC (NPI 1346590148) is a healthcare organization registered as a family medicine in Lumpkin, Georgia and active in the NPI registry since September 2012. The organization holds a CLIA Waiver certificate valid through June 9, 2027 and lists Sarita Darlene Mobley, Ceo, as its authorized official.

NPPES Registry Identity

NPI1346590148
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePROVIDENCE FAMILY MEDICINE CLINIC, INC
Location Address1787 BROAD STREET, PROVIDENCE FAMILY MEDICINE CLINIC, INCLumpkin, GA 31815
Mailing Address1787 Broad St., P.o. Box 685Lumpkin, GA 31815 · (703) 593-6154
Phone(703) 593-6154
Organization SubpartNo
Authorized OfficialSarita Darlene MobleyCeo · (703) 593-6154
Enumeration DateSeptember 19, 2012
✔ NPI 1346590148 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in GA · 046872
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1787 BROAD STREET, Lumpkin, GA 31815
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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 from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.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 11D2060225

Providence Family Medicine Clinic, Inc · Lumpkin, GA
Active · expires Jun 9, 2027
CLIA Number11D2060225
Laboratory TypePhysician Office
Certificate Effective DateJune 10, 2025
Certificate Expiration DateJune 9, 2027
Laboratory DirectorSarita D. Mobley
Laboratory Phone(229) 838-4900
Laboratory LocationProvidence Family Medicine Clinic, Inc1787 Broad Street, Room #9, Lumpkin, GA 31815
CLIA data matches this NPI record on: Address Name
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 Providence Family Medicine Clinic, Inc's NPI number?

The NPI number for Providence Family Medicine Clinic, Inc is 1346590148. It was assigned to this organization in the NPPES registry on September 19, 2012.

Where is Providence Family Medicine Clinic, Inc located?

Providence Family Medicine Clinic, Inc is located at 1787 Broad Street Providence Family Medicine Clinic, Inc, Lumpkin, GA 31815. The listed phone number is (703) 593-6154.

What is Providence Family Medicine Clinic, Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Providence Family Medicine Clinic, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2060225) is associated with this NPI, valid through June 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Providence Family Medicine Clinic, Inc accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Providence Family Medicine Clinic, Inc 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 Providence Family Medicine Clinic, Inc was last updated on September 19, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.