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BALIGA FAMILY PRACTICE PC
NPI 1700094562
Clinic/Center - Primary Care in Columbus, GA

Active since May 17, 2007CLIA 11D1069254 · Waiver
1400 BRADLEY LAKE BLVD, COLUMBUS, GA 31904(706) 593-7417(706) 507-2059 Get Directions Write a Review

NPPES record last updated: September 13, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 13, 2022, Apr 1, 2021, Aug 22, 2020 (3 updates tracked since 2020).

About Baliga Family Practice Pc NPPES

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

BALIGA FAMILY PRACTICE PC (NPI 1700094562) is a healthcare organization registered as a primary care in Columbus, Georgia and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through January 31, 2027 and lists Bantwal P Baliga, Physician, as its authorized official.

NPPES Registry Identity

NPI1700094562
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameBALIGA FAMILY PRACTICE PC
Location Address1400 BRADLEY LAKE BLVDColumbus, GA 31904-3688
Mailing Address1400 Bradley Lake BlvdColumbus, GA 31904-3688 · (706) 507-2050 · Fax (706) 507-2059
Phone(706) 593-7417
Fax(706) 507-2059
Organization SubpartNo
Authorized OfficialBantwal P BaligaPhysician · (706) 507-2050
Enumeration DateMay 17, 2007
Last NPPES UpdateSeptember 13, 20223 updates tracked since enumeration
NPPES CertifiedSeptember 13, 2022
✔ NPI 1700094562 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in GA · 056683
1400 BRADLEY LAKE BLVD, Columbus, GA 31904
Open in Google Maps ↗

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 11D1069254

Baliga Family Practice · Columbus, GA
Active · expires Jan 31, 2027
CLIA Number11D1069254
Laboratory TypePhysician Office
Certificate Effective DateFebruary 1, 2025
Certificate Expiration DateJanuary 31, 2027
Laboratory DirectorBantwal P. Baliga
Laboratory Phone(706) 507-2050
Laboratory LocationBaliga Family Practice1400 Bradley Lake Boulevard, Columbus, GA 31904
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 4

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

MS. SALLIE JEANETTE WACTER FNP-C
Nurse Practitioner (Family)
1400 BRADLEY LAKE BLVD
COLUMBUS, GA 31904
Muscogee County (706) 256-2525
MALLIKA THIRUPPATHI M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1400 BRADLEY LAKE BLVD
COLUMBUS, GA 31904
Muscogee County (334) 737-2737
BANTWAL PRATHIBHA BALIGA MD,DGO
Family Medicine
1400 BRADLEY LAKE BLVD
COLUMBUS, GA 31904
Muscogee County (706) 507-2050
MRS. KIMBERLY NICOLE EVANS FNP-BC
Nurse Practitioner (Family)
1400 BRADLEY LAKE BLVD
COLUMBUS, GA 31904
Muscogee County (706) 256-2525

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 Baliga Family Practice PC's NPI number?

The NPI number for Baliga Family Practice PC is 1700094562. It was assigned to this organization in the NPPES registry on May 17, 2007.

Where is Baliga Family Practice PC located?

Baliga Family Practice PC is located at 1400 Bradley Lake Blvd, Columbus, GA 31904. The listed phone number is (706) 593-7417.

What is Baliga Family Practice PC's specialty?

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

Does Baliga Family Practice PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D1069254) is associated with this NPI, valid through January 31, 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 Baliga Family Practice PC was last updated on September 13, 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.