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SOUTHERN ELITE CARE LLC
NPI 1366265449
Family Medicine in Tifton, GA

Active since November 06, 2024CLIA 11D2317676 · Waiver
1499 KENNEDY RD STE B, TIFTON, GA 31794(229) 238-3034(229) 238-3027 Get Directions Write a Review

NPPES record last updated: November 6, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Southern Elite Care Llc NPPES

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

SOUTHERN ELITE CARE LLC (NPI 1366265449) is a healthcare organization registered as a family medicine in Tifton, Georgia and active in the NPI registry since November 2024. The organization holds a CLIA Waiver certificate valid through January 28, 2027 and lists Jonathan W Tronolone, Owner, as its authorized official.

NPPES Registry Identity

NPI1366265449
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTHERN ELITE CARE LLC
Location Address1499 KENNEDY RD STE BTifton, GA 31794-4177
Mailing Address1499 Kennedy Rd Ste BTifton, GA 31794-4177 · (229) 238-3034 · Fax (229) 238-3027
Phone(229) 238-3034
Fax(229) 238-3027
Organization SubpartNo
Authorized OfficialJonathan W TronoloneOwner · (229) 238-3034
Enumeration DateNovember 6, 2024
NPPES CertifiedNovember 6, 2024
✔ NPI 1366265449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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.
1499 KENNEDY RD STE B, Tifton, GA 31794
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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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southern Elite Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Southern Elite Care LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Jonathan Tronolone, MD
Cardiovascular Disease (Cardiology)
NPI 1376626432
1499 KENNEDY RD STE C
Tifton, GA 31794
(229) 238-3034
✔ PECOS✔ Accepts MedicareSame address
Heath Parrish, FNP-C
Nurse Practitioner
NPI 1932464542
110 NORMAN DORMINY DR STE A
Fitzgerald, GA 31750
(229) 409-0874
✔ PECOS21 mi

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 11D2317676

Southern Elite Care · Tifton, GA
Active · expires Jan 28, 2027
CLIA Number11D2317676
Laboratory TypePhysician Office
Certificate Effective DateJanuary 29, 2025
Certificate Expiration DateJanuary 28, 2027
Laboratory DirectorJonathan W. Tronolone
Laboratory Phone(229) 920-4970
Laboratory LocationSouthern Elite Care1499 Kennedy Road, Tifton, GA 31794
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 Southern Elite Care LLC's NPI number?

The NPI number for Southern Elite Care LLC is 1366265449. It was assigned to this organization in the NPPES registry on November 6, 2024.

Where is Southern Elite Care LLC located?

Southern Elite Care LLC is located at 1499 Kennedy Rd Ste B, Tifton, GA 31794. The listed phone number is (229) 238-3034.

What is Southern Elite Care LLC's specialty?

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

Is Southern Elite Care LLC enrolled in Medicare?

Yes. Southern Elite Care LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southern Elite Care LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Southern Elite Care LLC, in Cardiovascular Disease (Cardiology) and Nurse Practitioner. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Southern Elite Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2317676) is associated with this NPI, valid through January 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southern Elite Care LLC was last updated on November 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.