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FCI JESUP
NPI 1508538679
Clinic/Center - Prison Health in Jesup, GA

Active since September 28, 2021CLIA 11D0702661 · Waiver
2600 HIGHWAY 301 SOUTH, JESUP, GA 31599(912) 427-0870 Get Directions Write a Review

NPPES record last updated: September 28, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fci Jesup NPPES

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

FCI JESUP (NPI 1508538679) is a healthcare organization registered as a prison health in Jesup, Georgia and active in the NPI registry since September 2021. The organization holds a CLIA Waiver certificate valid through July 16, 2028 and lists Patrick Tully, Chief Pharmacist, as its authorized official.

NPPES Registry Identity

NPI1508538679
Entity TypeOrganization
Primary Taxonomy261QP2400X
Legal Business NameFCI JESUP
Location Address2600 HIGHWAY 301 SOUTHJesup, GA 31599-0001
Mailing Address2600 Highway 301 SouthJesup, GA 31599-0001 · (912) 427-0870
Phone(912) 427-0870
Organization SubpartYesParent: Federal Bureau Of Prisons
Authorized OfficialPatrick TullyChief Pharmacist · (912) 427-0870
Enumeration DateSeptember 28, 2021
NPPES CertifiedSeptember 28, 2021
✔ NPI 1508538679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Prison HealthAmbulatory Health Care Facilities
Taxonomy Code261QP2400X
Also ListedPharmacy · Clinic PharmacyTaxonomy 3336C0002X
2600 HIGHWAY 301 SOUTH, Jesup, GA 31599
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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 11D0702661

Fci Jesup Georgia · Jesup, GA
Active · expires Jul 16, 2028
CLIA Number11D0702661
Laboratory TypeOther
Certificate Effective DateJuly 17, 2026
Certificate Expiration DateJuly 16, 2028
Laboratory DirectorDarren Martin
Laboratory Phone(912) 427-0870
Laboratory LocationFci Jesup Georgia2600 South Us Hwy 301, Jesup, GA 31545
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 Fci Jesup's NPI number?

The NPI number for Fci Jesup is 1508538679. It was assigned to this organization in the NPPES registry on September 28, 2021.

Where is Fci Jesup located?

Fci Jesup is located at 2600 Highway 301 South, Jesup, GA 31599. The listed phone number is (912) 427-0870.

What is Fci Jesup's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Prison Health, with taxonomy code 261QP2400X.

Does Fci Jesup hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0702661) is associated with this NPI, valid through July 16, 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 Fci Jesup was last updated on September 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.