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GA DIAGNOSTIC PROVIDERS LLC
NPI 1538768296
Clinic/Center - Sleep Disorder Diagnostic in Macon, GA

Active since October 22, 2020
5400 RIVERSIDE DR STE 202, MACON, GA 31210(478) 787-0059(855) 428-4597 Get Directions Write a Review

NPPES record last updated: February 21, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Feb 21, 2025, Oct 22, 2020 (2 updates tracked since 2020).

About Ga Diagnostic Providers Llc NPPES

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

GA DIAGNOSTIC PROVIDERS LLC (NPI 1538768296) is a healthcare organization registered as a sleep disorder diagnostic in Macon, Georgia and active in the NPI registry since October 2020. The organization maintains a secondary practice location in Warner Robins and lists Mark Shane Mobley, President, as its authorized official.

NPPES Registry Identity

NPI1538768296
Entity TypeOrganization
Primary Taxonomy261QS1200X
Legal Business NameGA DIAGNOSTIC PROVIDERS LLC
Location Address5400 RIVERSIDE DR STE 202Macon, GA 31210-0818
Mailing Address5400 Riverside Dr Ste 202Macon, GA 31210-0818 · (478) 972-8865 · Fax (855) 428-4597
Phone(478) 787-0059
Fax(855) 428-4597
Organization SubpartNo
Authorized OfficialMark Shane MobleyPresident · (478) 972-8865
Enumeration DateOctober 22, 2020
Last NPPES UpdateFebruary 21, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 21, 2025
✔ NPI 1538768296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/Center · Sleep Disorder DiagnosticAmbulatory Health Care Facilities
Taxonomy Code261QS1200X
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X
Also ListedPhysiological LaboratoryTaxonomy 293D00000X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
5400 RIVERSIDE DR STE 202, Macon, GA 31210
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Secondary Practice Location 1

Location 1100 Tommy Stalnaker Dr Ste AWarner Robins, GA 31088-1403 · Phone (478) 787-0059 · Fax (855) 428-4597

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ga Diagnostic Providers Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Ga Diagnostic Providers LLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Taylor Dickerson, NP-C
Nurse Practitioner
NPI 1073180774
5400 RIVERSIDE DR STE 202
Macon, GA 31210
(478) 787-0059
✔ PECOS✔ Accepts MedicareSame address
Anna Kleinberg, FNP
Nurse Practitioner
NPI 1598395592
5400 RIVERSIDE DR STE 202
Macon, GA 31210
(478) 787-0059
✔ PECOS✔ Accepts MedicareSame address
Haley Reynolds, FNP-C
Nurse Practitioner
NPI 1861909251
5400 RIVERSIDE DR STE 202
Macon, GA 31210
(855) 228-4597
✔ PECOS✔ Accepts MedicareSame address
Amber Romano, APRN, FNP-BC
Nurse Practitioner
NPI 1699407940
5400 RIVERSIDE DR STE 202
Macon, GA 31210
(855) 228-4597
✔ PECOS✔ Accepts MedicareSame address
Jessica Norris
Nurse Practitioner
NPI 1962277905
5400 RIVERSIDE DR STE 202
Macon, GA 31210
(478) 787-0059
✔ PECOS✔ Accepts MedicareSame address

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 Ga Diagnostic Providers LLC's NPI number?

The NPI number for Ga Diagnostic Providers LLC is 1538768296. It was assigned to this organization in the NPPES registry on October 22, 2020.

Where is Ga Diagnostic Providers LLC located?

Ga Diagnostic Providers LLC is located at 5400 Riverside Dr Ste 202, Macon, GA 31210. The listed phone number is (478) 787-0059.

What is Ga Diagnostic Providers LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Sleep Disorder Diagnostic, with taxonomy code 261QS1200X.

Is Ga Diagnostic Providers LLC enrolled in Medicare?

Yes. Ga Diagnostic Providers LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ga Diagnostic Providers LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Ga Diagnostic Providers LLC. 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, 5 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Ga Diagnostic Providers LLC was last updated on February 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.