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SOUTH GEORGIA MEDICINE, P.C.
NPI 1528126182
Internal Medicine - Gastroenterology in Tifton, GA

Active since December 05, 2006
1111 20TH ST E, TIFTON, GA 31794(229) 382-9338(229) 382-4282 Get Directions Write a Review

NPPES record last updated: June 21, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 21, 2021, Jun 3, 2021 (2 updates tracked since 2021).

About South Georgia Medicine, P.c. NPPES

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

SOUTH GEORGIA MEDICINE, P.C. (NPI 1528126182) is a healthcare organization registered as a gastroenterology in Tifton, Georgia and active in the NPI registry since December 2006. The organization lists Shirley Vickers Carrington, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1528126182
Entity TypeOrganization
Primary Taxonomy207RG0100X
Legal Business NameSOUTH GEORGIA MEDICINE, P.C.
Location Address1111 20TH ST ETifton, GA 31794-3689
Mailing Address1111 20th St ETifton, GA 31794-3689 · (229) 382-9338 · Fax (229) 382-4282
Phone(229) 382-9338
Fax(229) 382-4282
Organization SubpartNo
Authorized OfficialShirley Vickers CarringtonBilling Manager · (229) 382-9338
Enumeration DateDecember 5, 2006
Last NPPES UpdateJune 21, 20212 updates tracked since enumeration
NPPES CertifiedJune 21, 2021
✔ NPI 1528126182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in GA · 021582
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
1111 20TH ST E, Tifton, GA 31794
Open in Google Maps ↗

Other Identifiers 4

Other1023084000GA · Bcbs
Medicaid300029134AGA
Other11D090618GA · Clia
OtherCA5040GA · Railroad Medicare

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

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 Georgia Medicine, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to South Georgia Medicine, P.C., which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (3)

Misty Mcgough, FNP
Nurse Practitioner
NPI 1942884275
4 LIVE OAK CT
Moultrie, GA 31768
(229) 785-2400
✔ PECOS✔ Accepts Medicare27 mi
Don Roberts, MD
Gastroenterology
NPI 1780755918
4 LIVE OAK CT
Moultrie, GA 31768
(229) 785-2400
✔ PECOS✔ Accepts Medicare27 mi
Margarett Walden, NP-C
Nurse Practitioner
NPI 1477099661
853 N CHURCH ST STE 620
Spartanburg, SC 29303
(864) 573-7511
✔ PECOS✔ Accepts Medicare257 mi

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 Georgia Medicine, P.C.'s NPI number?

The NPI number for South Georgia Medicine, P.C. is 1528126182. It was assigned to this organization in the NPPES registry on December 5, 2006.

Where is South Georgia Medicine, P.C. located?

South Georgia Medicine, P.C. is located at 1111 20th St E, Tifton, GA 31794. The listed phone number is (229) 382-9338.

What is South Georgia Medicine, P.C.'s specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is South Georgia Medicine, P.C. enrolled in Medicare?

Yes. South Georgia Medicine, P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through South Georgia Medicine, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to South Georgia Medicine, P.C., in Gastroenterology 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. 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 Georgia Medicine, P.C. was last updated on June 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.