KEYS FERRY MEDICAL CENTER
NPI 1710058953
Family Medicine in Mcdonough, GA
About Keys Ferry Medical Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEYS FERRY MEDICAL CENTER (NPI 1710058953) is a healthcare organization registered as a family medicine in Mcdonough, Georgia and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2028 and lists William Harrell Van Laar, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Keys Ferry Medical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Keys Ferry Medical Center, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
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 11D0867368
Mcdonough Primary Care Inc · Mcdonough, GAFrequently 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 Mcdonough Primary Care Inc's NPI number?
The NPI number for Mcdonough Primary Care Inc is 1710058953. It was assigned to this organization in the NPPES registry on November 10, 2006. The provider is also known as Keys Ferry Medical Center.
Where is Mcdonough Primary Care Inc located?
Mcdonough Primary Care Inc is located at 68 Hampton St, Mcdonough, GA 30253. The listed phone number is (770) 914-0342.
What is Mcdonough Primary Care Inc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Mcdonough Primary Care Inc enrolled in Medicare?
Yes. Mcdonough Primary Care Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mcdonough Primary Care Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Mcdonough Primary Care Inc, in Family Practice and General Practice. 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Mcdonough Primary Care Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D0867368) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Mcdonough Primary Care Inc accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Mcdonough Primary Care Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mcdonough Primary Care Inc was last updated on November 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Keys Ferry Medical Center · NPI 1710058953
Family Medicine organization in Mcdonough, Georgia. Organization record, active in the CMS NPPES registry since November 10, 2006.
## Identity
- **NPI:** 1710058953 (Entity type: Organization)
- **Enumerated:** November 10, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Mcdonough Primary Care Inc
- **Organization subpart:** No
- **Authorized official:** William Van Laar, OWNER
## Practice location
- **Address:** 68 HAMPTON ST, Mcdonough, GA 30253-3150
- **Phone:** (770) 914-0342 · **Fax:** (770) 914-0493
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), General Practice (1); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 9, 2007
- **Other identifiers:** Medicare ID-Type Unspecified O1BDFLN (GA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1710058953) · Data from the CMS NPPES public registry.