SOUTHERN HEALTHCARE COLLABORATION, INC
NPI 1750087490
Nurse Practitioner - Primary Care in Baxley, GA

Q: What is Southern Healthcare Collaboration, Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Active since February 03, 2023CLIA 11D2273256 · Waiver

224 PEACHTREE ST, BAXLEY, GA 31513(912) 705-5483(912) 705-5484 Get Directions Write a Review

NPPES record last updated: March 24, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 24, 2026, Jul 10, 2024, Feb 3, 2023 (3 updates tracked since 2023).

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About Southern Healthcare Collaboration, Inc NPPES

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

SOUTHERN HEALTHCARE COLLABORATION, INC (NPI 1750087490) is a healthcare organization registered as a primary care in Baxley, Georgia and active in the NPI registry since February 2023. The organization holds a CLIA Waiver certificate valid through December 8, 2026 and lists Knicole Ann Lee, Owner, as its authorized official.

NPPES Registry Identity

NPI1750087490

Entity TypeOrganization

Primary Taxonomy363LP2300X

Legal Business NameSOUTHERN HEALTHCARE COLLABORATION, INC

Location Address224 PEACHTREE STBaxley, GA 31513-8079

Mailing Address224 Peachtree StBaxley, GA 31513-8079 · (912) 705-5483 · Fax (912) 705-5484

Phone(912) 705-5483

Fax(912) 705-5484

Organization SubpartNo

Authorized OfficialKnicole Ann LeeOwner · (912) 278-0410

Enumeration DateFebruary 3, 2023

Last NPPES UpdateMarch 24, 20263 updates tracked since enumeration

NPPES CertifiedMarch 24, 2026

✔ NPI 1750087490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X

Also ListedNurse PractitionerTaxonomy 363L00000X

224 PEACHTREE ST, Baxley, GA 31513

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Other Names 1

Doing Business AsSouthern Healthcare Collaboration, Inc

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 MULTIPLE 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 11D2273256

Southern Healthcare Collaboration, Inc · Baxley, GA

Active · expires Dec 8, 2026

CLIA Number11D2273256

Laboratory TypePhysician Office

Certificate Effective DateDecember 9, 2024

Certificate Expiration DateDecember 8, 2026

Laboratory DirectorKnicole A. Lee

Laboratory Phone(912) 705-5483

Laboratory LocationSouthern Healthcare Collaboration, Inc224 Peachtree Street, Baxley, GA 31513

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 2

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

SOUTHERN PRIMARY CARE AND BEHAVIORAL HEALTH SERVICES, LLC

Nurse Practitioner (Family)

224 PEACHTREE ST
BAXLEY, GA 31513

Appling County (912) 278-0410

MRS. KNICOLE A LEE DNP,FNP-BC

Nurse Practitioner (Family)

224 PEACHTREE ST
BAXLEY, GA 31513

Appling County (912) 705-5483

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 Healthcare Collaboration, Inc's NPI number?

The NPI number for Southern Healthcare Collaboration, Inc is 1750087490. It was assigned to this organization in the NPPES registry on February 3, 2023.

Where is Southern Healthcare Collaboration, Inc located?

Southern Healthcare Collaboration, Inc is located at 224 Peachtree St, Baxley, GA 31513. The listed phone number is (912) 705-5483.

What is Southern Healthcare Collaboration, Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Does Southern Healthcare Collaboration, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2273256) is associated with this NPI, valid through December 8, 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 Southern Healthcare Collaboration, Inc was last updated on March 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.