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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

GOOD SAMARITAN HEALTH & WELLNESS CENTER INC.
NPI 1407174675
Clinic/Center - Federally Qualified Health Center (FQHC) in Jasper, GA

Active since May 12, 2010CLIA 11D0996850 · Waiver
175 SAMARITAN DR, JASPER, GA 30143(706) 253-4673(706) 253-4675 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 29, 2026, Dec 4, 2025, Nov 3, 2025 and 1 more (4 updates tracked since 2020).

About Good Samaritan Health & Wellness Center Inc. NPPES

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

GOOD SAMARITAN HEALTH & WELLNESS CENTER INC. (NPI 1407174675) is a healthcare organization registered as a federally qualified health center (fqhc) in Jasper, Georgia and active in the NPI registry since May 2010. The organization holds a CLIA Waiver certificate valid through February 28, 2028 and lists Tammi W Sorrells, Ceo, as its authorized official.

NPPES Registry Identity

NPI1407174675
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameGOOD SAMARITAN HEALTH & WELLNESS CENTER INC.
Location Address175 SAMARITAN DRJasper, GA 30143-1964
Mailing Address175 Samaritan DrJasper, GA 30143-1964 · (706) 253-4633 · Fax (706) 253-4631
Phone(706) 253-4673
Fax(706) 253-4675
Organization SubpartNo
Authorized OfficialTammi W SorrellsCeo · (770) 815-0986
Enumeration DateMay 12, 2010
Last NPPES UpdateSeptember 29, 20264 updates tracked since enumeration
NPPES CertifiedSeptember 29, 2026
✔ NPI 1407174675 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedClinic/CenterTaxonomy 261Q00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
175 SAMARITAN DR, Jasper, GA 30143
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

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)

Good Samaritan Health & Wellness Center Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

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.

StateEnrollment IDDue date
StateGeorgiaEnrollment IDO20120926000639Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Good Samaritan Health & Wellness Center Inc., which bills Medicare for the services they deliver. Of these, 5 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Makaylie Gibbs
Nurse Practitioner
NPI 1811884992
175 SAMARITAN DR
Jasper, GA 30143
(706) 253-4633
✔ PECOSSame address
Walter Austin, MD
Cardiovascular Disease (Cardiology)
NPI 1548265838
175 SAMARITAN DR
Jasper, GA 30143
(706) 253-4633
✔ PECOSSame address
Julia Ceglenski, MD
Family Practice
NPI 1073263604
175 SAMARITAN DR
Jasper, GA 30143
(706) 253-4633
✔ PECOSSame address
Patti Shelby, FNP
Nurse Practitioner
NPI 1932680451
175 SAMARITAN DR
Jasper, GA 30143
(706) 253-4673
✔ PECOSSame address
Julie Everett, LCSW
Clinical Social Worker
NPI 1407475734
175 SAMARITAN DR
Jasper, GA 30143
(706) 253-4673
✔ PECOSSame address
Michael Christian
Nurse Practitioner
NPI 1699252387
1802 REFUGE RD
Jasper, GA 30143
(706) 253-4633
✔ PECOS✔ Accepts Medicare0.9 mi
Carol Spencer, LCSW
Clinical Social Worker
NPI 1023567195
3905 GRISSOM PKWY
Cocoa, FL 32926
(321) 637-1866
✔ PECOS468 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 11D0996850

Good Samaritan Health And Wellness Center · Jasper, GA
Active · expires Feb 28, 2028
CLIA Number11D0996850
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateFebruary 28, 2026
Certificate Expiration DateFebruary 28, 2028
Laboratory DirectorTammi W. Sorrells
Laboratory Phone(706) 253-4673
Laboratory LocationGood Samaritan Health And Wellness Center175 Samaritan Drive, Jasper, GA 30143
CLIA data matches this NPI record on: Address 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 Good Samaritan Health & Wellness Center Inc.'s NPI number?

The NPI number for Good Samaritan Health & Wellness Center Inc. is 1407174675. It was assigned to this organization in the NPPES registry on May 12, 2010.

Where is Good Samaritan Health & Wellness Center Inc. located?

Good Samaritan Health & Wellness Center Inc. is located at 175 Samaritan Dr, Jasper, GA 30143. The listed phone number is (706) 253-4673.

What is Good Samaritan Health & Wellness Center Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Is Good Samaritan Health & Wellness Center Inc. enrolled in Medicare?

Yes. Good Samaritan Health & Wellness Center Inc. is registered in the Medicare PECOS enrollment system.

When is Good Samaritan Health & Wellness Center Inc.'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 November 30, 2026. 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 Good Samaritan Health & Wellness Center Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 4 Medicare specialties reassign their Medicare billing to Good Samaritan Health & Wellness Center Inc.. 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 (3), Clinical Social Worker (2) and Cardiovascular Disease (Cardiology) (1). Of these, 5 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Good Samaritan Health & Wellness Center Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0996850) is associated with this NPI, valid through February 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Good Samaritan Health & Wellness Center Inc. accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 46 other insurers list Good Samaritan Health & Wellness Center 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 Good Samaritan Health & Wellness Center Inc. was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 32 days 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.