KINGS BAY FAMILY CARE
NPI 1477698611
Family Medicine in Saint Marys, GA

Q: What is Lacanilao Medical Management PC's NPI number?

The NPI number for Lacanilao Medical Management PC is 1477698611. It was assigned to this organization in the NPPES registry on February 21, 2007. The provider is doing business as Kings Bay Family Care.

Q: What is Lacanilao Medical Management PC's specialty?

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

Active since February 21, 2007CLIA 11D2313562 · Waiver

340 CHARLIE SMITH SR HWY, SAINT MARYS, GA 31558(912) 882-5030(888) 476-5235 Get Directions Write a Review

NPPES record last updated: December 20, 2012. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Kings Bay Family Care NPPES

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

KINGS BAY FAMILY CARE (NPI 1477698611) is a healthcare organization registered as a family medicine in Saint Marys, Georgia and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through November 3, 2026 and lists Angelito Buencamino Lacanilao, President, as its authorized official.

NPPES Registry Identity

NPI1477698611

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameLACANILAO MEDICAL MANAGEMENT PC

Location Address340 CHARLIE SMITH SR HWYSaint Marys, GA 31558-3101

Mailing Address340 Charlie Smith Sr HwySaint Marys, GA 31558-3101 · (912) 882-5030 · Fax (888) 476-5235

Phone(912) 882-5030

Fax(888) 476-5235

Organization SubpartNo

Authorized OfficialAngelito Buencamino LacanilaoPresident · (912) 882-5030

Enumeration DateFebruary 21, 2007

Last NPPES UpdateDecember 20, 2012

✔ NPI 1477698611 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 · 052769

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.

340 CHARLIE SMITH SR HWY, Saint Marys, GA 31558

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Other Names 1

Doing Business AsKings Bay Family Care

Other Identifiers 5

Other1477698611GA · Npi

Medicare UPINH84791GA

Medicaid083558714BGA

OtherGRP6277GA · Medicare Ptan

Medicare ID-Type Unspecified08BBQQDGA

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

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 11D2313562

Kings Bay Family Care · Saint Marys, GA

Active · expires Nov 3, 2026

CLIA Number11D2313562

Laboratory TypePhysician Office

Certificate Effective DateNovember 4, 2024

Certificate Expiration DateNovember 3, 2026

Laboratory DirectorAngelito Lacanilao

Laboratory Phone(912) 882-5030

Laboratory LocationKings Bay Family Care88 Lindsey Lane, Suite B, Saint Marys, GA 31558

CLIA data matches this NPI record on: Name 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 Lacanilao Medical Management PC's NPI number?

The NPI number for Lacanilao Medical Management PC is 1477698611. It was assigned to this organization in the NPPES registry on February 21, 2007. The provider is doing business as Kings Bay Family Care.

Where is Lacanilao Medical Management PC located?

Lacanilao Medical Management PC is located at 340 Charlie Smith Sr Hwy, Saint Marys, GA 31558. The listed phone number is (912) 882-5030.

What is Lacanilao Medical Management PC's specialty?

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

Does Lacanilao Medical Management PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2313562) is associated with this NPI, valid through November 3, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lacanilao Medical Management PC was last updated on December 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.