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SOUTHERN FAMILY MEDICINE LLC
NPI 1528299393
Family Medicine in Statesboro, GA

Active since July 28, 2009CLIA Certified · 2 labs
1140 BRAMPTON AVE, STATESBORO, GA 30458(912) 871-2273(912) 872-3374 Get Directions Write a Review

NPPES record last updated: August 8, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 8, 2023, Aug 9, 2019, Sep 4, 2018 and 2 more (5 updates tracked since 2017).

About Southern Family Medicine Llc NPPES

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

SOUTHERN FAMILY MEDICINE LLC (NPI 1528299393), doing business as Tri-care Family Medicine Llc, is a healthcare organization registered as a family medicine in Statesboro, Georgia and active in the NPI registry since July 2009. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Claxton, and lists Cindy R Rush, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1528299393
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTHERN FAMILY MEDICINE OF GEORGIA, LLC
Location Address1140 BRAMPTON AVEStatesboro, GA 30458
Mailing Address1140 Brampton AveStatesboro, GA 30458 · (912) 871-2273 · Fax (912) 871-2274
Phone(912) 871-2273
Fax(912) 872-3374
Organization SubpartNo
Authorized OfficialCindy R RushBilling Manager · (912) 290-5235
Enumeration DateJuly 28, 2009
Last NPPES UpdateAugust 8, 20235 updates tracked since enumeration
NPPES CertifiedAugust 8, 2023
✔ NPI 1528299393 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 · 43354
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.
1140 BRAMPTON AVE, Statesboro, GA 30458
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Other Names 2

Other NameSouthern Family Medicine Llc
Former Legal Business NameTri-care Family Medicine Llc

Secondary Practice Location 1

Location 1308 E Long StClaxton, GA 30417-1412 · Phone (912) 290-5235 · Fax (912) 290-5236

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

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 11D1104838

Southern Family Medicine Of Georgia, LLC · Statesboro, GA
Active · expires Sep 10, 2027
CLIA Number11D1104838
Laboratory TypePhysician Office
Certificate Effective DateSeptember 11, 2025
Certificate Expiration DateSeptember 10, 2027
Laboratory DirectorGlen J. Dasher
Laboratory Phone(912) 871-2273
Laboratory LocationSouthern Family Medicine Of Georgia, LLC1140 Brampton Avenue, Statesboro, GA 30458
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2064698

Southern Family Medicine Of Georgia, LLC · Claxton, GA
Active · expires Aug 25, 2027
CLIA Number11D2064698
Laboratory TypePhysician Office
Certificate Effective DateAugust 26, 2025
Certificate Expiration DateAugust 25, 2027
Laboratory DirectorThomas J. Miller Jr
Laboratory Phone(912) 290-5235
Laboratory LocationSouthern Family Medicine Of Georgia, LLC308 East Long Street, Claxton, GA 30417
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. KACY H. NESMITH FNP
Nurse Practitioner (Family)
1140 BRAMPTON AVE
STATESBORO, GA 30458
Bulloch County (912) 871-2273
MRS. JORDYN LEWIS FNP
Nurse Practitioner (Family)
1140 BRAMPTON AVE
STATESBORO, GA 30458
Bulloch County (912) 871-2273
DR. LUKE DANIEL KRAUTTER M.D.
Family Medicine
1140 BRAMPTON AVE
STATESBORO, GA 30458
Bulloch County (912) 871-2273

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 Southern Family Medicine Of Georgia, LLC's NPI number?

The NPI number for Southern Family Medicine Of Georgia, LLC is 1528299393. It was assigned to this organization in the NPPES registry on July 28, 2009. The provider is also known as Southern Family Medicine LLC. The provider was formerly known as Tri-Care Family Medicine LLC.

Where is Southern Family Medicine Of Georgia, LLC located?

Southern Family Medicine Of Georgia, LLC is located at 1140 Brampton Ave, Statesboro, GA 30458. The listed phone number is (912) 871-2273.

What is Southern Family Medicine Of Georgia, LLC's specialty?

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

Does Southern Family Medicine Of Georgia, LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Southern Family Medicine Of Georgia, LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Southern Family Medicine Of Georgia, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southern Family Medicine Of Georgia, LLC was last updated on August 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.