CAMILLA MEDICAL CLINIC
NPI 1760005144
Family Medicine in Camilla, GA
About Camilla Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CAMILLA MEDICAL CLINIC (NPI 1760005144) is a healthcare organization registered as a family medicine in Camilla, Georgia and active in the NPI registry since May 2020. The organization holds a CLIA Waiver certificate valid through July 14, 2028 and lists Kitty Beasley, General Partner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Camilla Medical Clinic 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 Camilla Medical Clinic, which bills Medicare for the services they deliver. Of these, 1 practice at this address. 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 11D2188302
Camilla Medical Clinic · Camilla, 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 Camilla Medical Clinic's NPI number?
The NPI number for Camilla Medical Clinic is 1760005144. It was assigned to this organization in the NPPES registry on May 20, 2020.
Where is Camilla Medical Clinic located?
Camilla Medical Clinic is located at 138 E Broad St, Camilla, GA 31730. The listed phone number is (229) 351-4125.
What is Camilla Medical Clinic's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Camilla Medical Clinic enrolled in Medicare?
Yes. Camilla Medical Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Camilla Medical Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Camilla Medical Clinic, in Family Practice and Nurse Practitioner. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Camilla Medical Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D2188302) is associated with this NPI, valid through July 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Camilla Medical Clinic accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Camilla Medical Clinic 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 Camilla Medical Clinic was last updated on May 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Camilla Medical Clinic · NPI 1760005144
Family Medicine organization in Camilla, Georgia. Organization record, active in the CMS NPPES registry since May 20, 2020.
## Identity
- **NPI:** 1760005144 (Entity type: Organization)
- **Enumerated:** May 20, 2020
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Kitty Beasley, GENERAL PARTNER
## Practice location
- **Address:** 138 E BROAD ST, Camilla, GA 31730-1809
- **Phone:** (229) 351-4125
## 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), Nurse Practitioner (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 20, 2020
- **Other identifiers:** Other XXX
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1760005144) · Data from the CMS NPPES public registry.