KINGS BAY FAMILY CARE
NPI 1477698611
Family Medicine in Saint Marys, GA
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, 2028 and lists Angelito Buencamino Lacanilao, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 5
Group Practice 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)
Kings Bay Family Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Kings Bay Family Care, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
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 11D2313562
Kings Bay Family Care · Saint Marys, GAFrequently 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.
Is Lacanilao Medical Management PC enrolled in Medicare?
Yes. Lacanilao Medical Management PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lacanilao Medical Management PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Lacanilao Medical Management PC, in Family Practice 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, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, 2028. 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.
# Kings Bay Family Care · NPI 1477698611
Family Medicine organization in Saint Marys, Georgia. Organization record, active in the CMS NPPES registry since February 21, 2007.
## Identity
- **NPI:** 1477698611 (Entity type: Organization)
- **Enumerated:** February 21, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Lacanilao Medical Management Pc
- **Organization subpart:** No
- **Authorized official:** Angelito Lacanilao, PRESIDENT
## Practice location
- **Address:** 340 CHARLIE SMITH SR HWY, Saint Marys, GA 31558-3101
- **Phone:** (912) 882-5030 · **Fax:** (888) 476-5235
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Nurse Practitioner (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 20, 2012
- **Other identifiers:** Other 1477698611 (GA); Medicare UPIN H84791 (GA); Medicaid 083558714B (GA); and 2 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1477698611) · Data from the CMS NPPES public registry.