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PEACHTREE FAMILY MEDICINE, LLC.
NPI 1700608353
Family Medicine in Jesup, GA

Active since October 25, 2024CLIA 11D2313640 · Waiver
330 PEACHTREE ST, JESUP, GA 31545(912) 415-8552 Get Directions Write a Review

NPPES record last updated: December 4, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Peachtree Family Medicine, Llc. NPPES

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

PEACHTREE FAMILY MEDICINE, LLC. (NPI 1700608353) is a healthcare organization registered as a family medicine in Jesup, Georgia and active in the NPI registry since October 2024. The organization holds a CLIA Waiver certificate valid through November 4, 2026 and lists Jennifer Holly Jones, Owner, as its authorized official.

NPPES Registry Identity

NPI1700608353
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePEACHTREE FAMILY MEDICINE, LLC.
Location Address330 PEACHTREE STJesup, GA 31545-0246
Mailing Address1414 Ogden LoopOdum, GA 31555 · (912) 415-8552
Phone(912) 415-8552
Organization SubpartNo
Authorized OfficialJennifer Holly JonesOwner · (912) 415-8552
Enumeration DateOctober 25, 2024
Last NPPES UpdateDecember 4, 2024
NPPES CertifiedDecember 4, 2024
✔ NPI 1700608353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
330 PEACHTREE ST, Jesup, GA 31545
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 11D2313640

Peachtree Family Medicine · Jesup, GA
Active · expires Nov 4, 2026
CLIA Number11D2313640
Laboratory TypePhysician Office
Certificate Effective DateNovember 5, 2024
Certificate Expiration DateNovember 4, 2026
Laboratory DirectorJennifer Jones
Laboratory Phone(912) 415-8552
Laboratory LocationPeachtree Family Medicine330 Peachtree Street, Jesup, GA 31545
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 8

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

DR. DOUGLAS P HEIN MD
Orthopaedic Surgery
330 PEACHTREE ST, SUITE 2
JESUP, GA 31545
Wayne County (912) 427-6915
GRACE CARYN PRINCE LEE FNP-C
Nurse Practitioner (Family)
330 PEACHTREE ST
JESUP, GA 31545
Wayne County (912) 415-8552
JENNIFER HOLLY JONES FNP-BC
Nurse Practitioner (Family)
330 PEACHTREE ST
JESUP, GA 31545
Wayne County (912) 427-6964
CANDIDE PHYSICAL THERAPY, LLC
Physical Medicine & Rehabilitation
330 PEACHTREE ST
JESUP, GA 31545
Wayne County (912) 207-0242
TANDY M SMITH MSN, APRN, FNP-BC
Nurse Practitioner (Family)
330 PEACHTREE ST
JESUP, GA 31545
Wayne County (912) 427-6964
KAYLA MATHIE FNP-C
Nurse Practitioner (Family)
330 PEACHTREE ST
JESUP, GA 31545
Wayne County (912) 415-8552
ROBERT L. PHILLIPS M.D.
Family Medicine
330 PEACHTREE ST
JESUP, GA 31545
Wayne County (912) 427-6964
WAYNE SJC MEDICAL GROUP, LLC
Orthopaedic Surgery
330 PEACHTREE ST, SUITE 2
JESUP, GA 31545
Wayne County (912) 427-6915

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 Peachtree Family Medicine, LLC.'s NPI number?

The NPI number for Peachtree Family Medicine, LLC. is 1700608353. It was assigned to this organization in the NPPES registry on October 25, 2024.

Where is Peachtree Family Medicine, LLC. located?

Peachtree Family Medicine, LLC. is located at 330 Peachtree St, Jesup, GA 31545. The listed phone number is (912) 415-8552.

What is Peachtree Family Medicine, LLC.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Peachtree Family Medicine, LLC. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2313640) is associated with this NPI, valid through November 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Peachtree Family Medicine, LLC. was last updated on December 4, 2024. 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.