BURKETT FAMILY PRACTICE, LLC
NPI 1669180741
Clinic/Center - Primary Care in Hazlehurst, GA

Q: What is Burkett Family Practice, LLC's NPI number?

The NPI number for Burkett Family Practice, LLC is 1669180741. It was assigned to this organization in the NPPES registry on November 8, 2022.

Q: What is Burkett Family Practice, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Active since November 08, 2022CLIA 11D2294782 · Waiver

38 S TALLAHASSEE ST STE B, HAZLEHURST, GA 31539(912) 699-8800(912) 699-8801 Get Directions Write a Review

NPPES record last updated: November 8, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Burkett Family Practice, Llc NPPES

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

BURKETT FAMILY PRACTICE, LLC (NPI 1669180741) is a healthcare organization registered as a primary care in Hazlehurst, Georgia and active in the NPI registry since November 2022. The organization holds a CLIA Waiver certificate valid through November 29, 2027 and lists Angela Marie Burkett, Family Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1669180741

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameBURKETT FAMILY PRACTICE, LLC

Location Address38 S TALLAHASSEE ST STE BHazlehurst, GA 31539-6261

Mailing Address38 S Tallahassee St Ste BHazlehurst, GA 31539-6261 · (912) 699-8800 · Fax (912) 699-8801

Phone(912) 699-8800

Fax(912) 699-8801

Organization SubpartNo

Authorized OfficialAngela Marie BurkettFamily Nurse Practitioner · (912) 699-8800

Enumeration DateNovember 8, 2022

NPPES CertifiedNovember 8, 2022

✔ NPI 1669180741 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

38 S TALLAHASSEE ST STE B, Hazlehurst, GA 31539

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Burkett Family Practice, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Burkett Family Practice, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Angela Burkett, FNP-C

Nurse Practitioner

NPI 1043666860

38 S TALLAHASSEE ST STE B
Hazlehurst, GA 31539

(912) 699-8800

✔ 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.

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 11D2294782

Burkett Family Practice, LLC · Hazlehurst, GA

Active · expires Nov 29, 2027

CLIA Number11D2294782

Laboratory TypePhysician Office

Certificate Effective DateNovember 30, 2025

Certificate Expiration DateNovember 29, 2027

Laboratory DirectorAngela M. Burkett

Laboratory Phone(912) 699-8800

Laboratory LocationBurkett Family Practice, LLC38 S Tallahassee Street, Suite B, Hazlehurst, GA 31539

CLIA data matches this NPI record on: Address 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 Burkett Family Practice, LLC's NPI number?

The NPI number for Burkett Family Practice, LLC is 1669180741. It was assigned to this organization in the NPPES registry on November 8, 2022.

Where is Burkett Family Practice, LLC located?

Burkett Family Practice, LLC is located at 38 S Tallahassee St Ste B, Hazlehurst, GA 31539. The listed phone number is (912) 699-8800.

What is Burkett Family Practice, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Burkett Family Practice, LLC enrolled in Medicare?

Yes. Burkett Family Practice, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Burkett Family Practice, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Burkett Family Practice, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Burkett Family Practice, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2294782) is associated with this NPI, valid through November 29, 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 Burkett Family Practice, LLC was last updated on November 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.