MEMORIAL PEDIATRICS
NPI 1629596853
Clinic/Center - Multi-Specialty in Bainbridge, GA

Active since September 08, 2017CLIA 11D0958567 · Microscopy
603 WHEAT AVE STE 450, BAINBRIDGE, GA 39819(229) 243-7707 Get Directions Write a Review

NPPES record last updated: September 8, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Memorial Pediatrics NPPES

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

MEMORIAL PEDIATRICS (NPI 1629596853) is a healthcare organization registered as a multi-specialty in Bainbridge, Georgia and active in the NPI registry since September 2017. The organization holds a CLIA Microscopy certificate valid through February 7, 2027 and lists Karen Faircloth, Cfo, as its authorized official.

NPPES Registry Identity

NPI1629596853
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameHOSPITAL AUTHORITY OF THE CITY OF BAINBRIDGE AND DECATUR COUNTY GEORGI
Location Address603 WHEAT AVE STE 450Bainbridge, GA 39819-4365
Mailing Address1500 E Shotwell StBainbridge, GA 39819-4256 · (229) 243-1700 · Fax (229) 246-9322
Organization SubpartNo
Authorized OfficialKaren FairclothCfo · (229) 246-8211
Enumeration DateSeptember 8, 2017
NPI 1629596853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
603 WHEAT AVE STE 450, Bainbridge, GA 39819

Other Names 1

Doing Business AsMemorial Pediatrics

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 for Provider-Performed Microscopy Procedures (PPMP) 11D0958567

Memorial Pediatrics · Bainbridge, GA
Active · expires Feb 7, 2027
CLIA Number11D0958567
Laboratory TypePhysician Office
Certificate Effective DateFebruary 8, 2025
Certificate Expiration DateFebruary 7, 2027
Laboratory DirectorDr. Mandy S. Moye
Laboratory Phone(229) 243-1209
Laboratory LocationMemorial Pediatrics603 South Wheat Avenue, Suite 450, Bainbridge, GA 39819
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform 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.

Nurse Practitioner (Family)
603 WHEAT AVE STE 450
BAINBRIDGE, GA 39819
Pediatrics
603 WHEAT AVE STE 450
BAINBRIDGE, GA 39819
Pediatrics
603 WHEAT AVE STE 450
BAINBRIDGE, GA 39819

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 Hospital Authority Of The City Of Bainbridge And Decatur County Georgi's NPI number?

The NPI number for Hospital Authority Of The City Of Bainbridge And Decatur County Georgi is 1629596853. It was assigned to this organization in the NPPES registry on September 8, 2017. The provider is doing business as Memorial Pediatrics.

Where is Hospital Authority Of The City Of Bainbridge And Decatur County Georgi located?

Hospital Authority Of The City Of Bainbridge And Decatur County Georgi is located at 603 Wheat Ave Ste 450, Bainbridge, GA 39819. The listed phone number is (229) 243-7707.

What is Hospital Authority Of The City Of Bainbridge And Decatur County Georgi's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Hospital Authority Of The City Of Bainbridge And Decatur County Georgi hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 11D0958567) is associated with this NPI, valid through February 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Hospital Authority Of The City Of Bainbridge And Decatur County Georgi was last updated on September 8, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.