SOUTH CENTRAL PRIMARY CARE- ASHLEY STREET
NPI 1467223818
Clinic/Center - Federally Qualified Health Center (FQHC) in Valdosta, GA
About South Central Primary Care- Ashley Street NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH CENTRAL PRIMARY CARE- ASHLEY STREET (NPI 1467223818) is a healthcare organization registered as a federally qualified health center (fqhc) in Valdosta, Georgia and active in the NPI registry since January 2024. The organization lists Robert Bonds Tucker, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
South Central Primary Care- Ashley Street is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to South Central Primary Care- Ashley Street, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: 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 South Central Primary Care Center, Inc's NPI number?
The NPI number for South Central Primary Care Center, Inc is 1467223818. It was assigned to this organization in the NPPES registry on January 15, 2024. The provider is doing business as South Central Primary Care- Ashley Street.
Where is South Central Primary Care Center, Inc located?
South Central Primary Care Center, Inc is located at 2301 N Ashley St, Valdosta, GA 31602. The listed phone number is (229) 468-9166.
What is South Central Primary Care 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 South Central Primary Care Center, Inc enrolled in Medicare?
Yes. South Central Primary Care Center, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through South Central Primary Care Center, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to South Central Primary Care 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for South Central Primary Care Center, Inc was last updated on November 20, 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.
# South Central Primary Care- Ashley Street · NPI 1467223818
Federally Qualified Health Center (FQHC) organization in Valdosta, Georgia. Organization record, active in the CMS NPPES registry since January 15, 2024.
## Identity
- **NPI:** 1467223818 (Entity type: Organization)
- **Enumerated:** January 15, 2024
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** South Central Primary Care Center, Inc
- **Organization subpart:** No
- **Authorized official:** Robert Tucker, CEO
## Practice location
- **Address:** 2301 N ASHLEY ST, Valdosta, GA 31602-2620
- **Phone:** (229) 468-9166
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 20, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1467223818) · Data from the CMS NPPES public registry.