SOUTHERN HEALTHCARE COLLABORATION, INC
NPI 1750087490
Nurse Practitioner - Primary Care in Baxley, GA
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
Specialties & Licenses 5
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southern Healthcare Collaboration, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
7Medicare enrollment records show 7 clinicians reassign Medicare billing to Southern Healthcare Collaboration, Inc, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (7)
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 11D2273256
Southern Healthcare Collaboration, Inc · Baxley, 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 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.
Is Southern Healthcare Collaboration, Inc enrolled in Medicare?
Yes. Southern Healthcare Collaboration, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern Healthcare Collaboration, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Southern Healthcare Collaboration, Inc. 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. The largest specialties are Nurse Practitioner (4), Family Practice (2) and Psychiatry (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 7 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.
# Southern Healthcare Collaboration, Inc · NPI 1750087490
Primary Care organization in Baxley, Georgia. Organization record, active in the CMS NPPES registry since February 3, 2023.
## Identity
- **NPI:** 1750087490 (Entity type: Organization)
- **Enumerated:** February 3, 2023
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **Also known as:** Southern Healthcare Collaboration, INC (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Knicole Lee, OWNER
## Practice location
- **Address:** 224 PEACHTREE ST, Baxley, GA 31513-8079
- **Phone:** (912) 705-5483 · **Fax:** (912) 705-5484
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 7 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (4), Family Practice (2), Psychiatry (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 24, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1750087490) · Data from the CMS NPPES public registry.