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SOUTHERN ROOTS DPC LLC
NPI 1710870944
General Practice in Adel, GA

Active since May 28, 2025CLIA 11D2326797 · Waiver
407 N PARRISH AVE, ADEL, GA 31620(229) 300-3642 Get Directions Write a Review

NPPES record last updated: June 10, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 10, 2025, May 28, 2025 (2 updates tracked since 2025).

About Southern Roots Dpc Llc NPPES

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

SOUTHERN ROOTS DPC LLC (NPI 1710870944) is a healthcare organization registered as a general practice in Adel, Georgia and active in the NPI registry since May 2025. The organization holds a CLIA Waiver certificate valid through July 9, 2027 and lists Summer Alvarez, Co Owner And Physician, as its authorized official.

NPPES Registry Identity

NPI1710870944
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameSOUTHERN ROOTS DPC LLC
Location Address407 N PARRISH AVEAdel, GA 31620-2076
Mailing Address6888 Mcneal RdHahira, GA 31632-2029 · (229) 300-3642
Phone(229) 300-3642
Organization SubpartNo
Authorized OfficialSummer AlvarezCo Owner And Physician · (229) 300-3642
Enumeration DateMay 28, 2025
Last NPPES UpdateJune 10, 20252 updates tracked since enumeration
NPPES CertifiedJune 10, 2025
✔ NPI 1710870944 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

407 N PARRISH AVE, Adel, GA 31620
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

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 11D2326797

Southern Roots Dpc, LLC · Adel, GA
Active · expires Jul 9, 2027
CLIA Number11D2326797
Laboratory TypePhysician Office
Certificate Effective DateJuly 10, 2025
Certificate Expiration DateJuly 9, 2027
Laboratory DirectorSummer B. Alvarez
Laboratory Phone(229) 300-3642
Laboratory LocationSouthern Roots Dpc, LLC407 North Parrish Avenue, Adel, GA 31620
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

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

DR. JAIRAJ GOBERDHAN M.D.
Family Medicine
407 N PARRISH AVE
ADEL, GA 31620
Cook County (229) 896-1672

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 Southern Roots Dpc LLC's NPI number?

The NPI number for Southern Roots Dpc LLC is 1710870944. It was assigned to this organization in the NPPES registry on May 28, 2025.

Where is Southern Roots Dpc LLC located?

Southern Roots Dpc LLC is located at 407 N Parrish Ave, Adel, GA 31620. The listed phone number is (229) 300-3642.

What is Southern Roots Dpc LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Southern Roots Dpc LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2326797) is associated with this NPI, valid through July 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Southern Roots Dpc LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Southern Roots Dpc LLC 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 Southern Roots Dpc LLC was last updated on June 10, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.