Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MIDDLE GA FAMILY PRACTICE LLC
NPI 1669325643
Clinic/Center - Primary Care in Eastman, GA

Q: What is Middle Ga Family Practice LLC's NPI number?

The NPI number for Middle Ga Family Practice LLC is 1669325643. It was assigned to this organization in the NPPES registry on February 18, 2026.

Q: What is Middle Ga 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 February 18, 2026CLIA 11D2344636 · Waiver

1085 PLAZA AVE STE A, EASTMAN, GA 31023(478) 220-5444(478) 559-1073 Get Directions Write a Review

NPPES record last updated: July 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 6, 2026, Mar 17, 2026, Mar 11, 2026 and 1 more (4 updates tracked since 2026).

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About Middle Ga Family Practice Llc NPPES

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

MIDDLE GA FAMILY PRACTICE LLC (NPI 1669325643) is a healthcare organization registered as a primary care in Eastman, Georgia and active in the NPI registry since February 2026. The organization holds a CLIA Waiver certificate valid through May 26, 2028 and lists Jina J Fordham, Manager, as its authorized official.

NPPES Registry Identity

NPI1669325643

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameMIDDLE GA FAMILY PRACTICE LLC

Location Address1085 PLAZA AVE STE AEastman, GA 31023-9102

Mailing Address1085 Plaza Ave Ste AEastman, GA 31023-9102 · (478) 220-5444 · Fax (478) 559-1073

Phone(478) 220-5444

Fax(478) 559-1073

Organization SubpartNo

Authorized OfficialJina J FordhamManager · (478) 220-5444

Enumeration DateFebruary 18, 2026

Last NPPES UpdateJuly 6, 20264 updates tracked since enumeration

NPPES CertifiedJuly 6, 2026

✔ NPI 1669325643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

1085 PLAZA AVE STE A, Eastman, GA 31023

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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 11D2344636

Middle Ga Family Practice · Eastman, GA

Active · expires May 26, 2028

CLIA Number11D2344636

Laboratory TypePractitioner Other

Certificate Effective DateMay 27, 2026

Certificate Expiration DateMay 26, 2028

Laboratory DirectorZachary B. Chaney

Laboratory Phone(478) 220-5444

Laboratory LocationMiddle Ga Family Practice1085 Plaza Avenue, Suite A, Eastman, GA 31023

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 Middle Ga Family Practice LLC's NPI number?

The NPI number for Middle Ga Family Practice LLC is 1669325643. It was assigned to this organization in the NPPES registry on February 18, 2026.

Where is Middle Ga Family Practice LLC located?

Middle Ga Family Practice LLC is located at 1085 Plaza Ave Ste A, Eastman, GA 31023. The listed phone number is (478) 220-5444.

What is Middle Ga Family Practice LLC's specialty?

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

Does Middle Ga Family Practice LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2344636) is associated with this NPI, valid through May 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Middle Ga Family Practice LLC was last updated on July 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 35 days 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.