CAMILLA MEDICAL CLINIC
NPI 1760005144
Family Medicine in Camilla, GA

Active since May 20, 2020CLIA 11D2188302 · Waiver
138 E BROAD ST, CAMILLA, GA 31730(229) 351-4125 Get Directions Write a Review

NPPES record last updated: May 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1760005144
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCAMILLA MEDICAL CLINIC
Location Address138 E BROAD STCamilla, GA 31730-1809
Mailing Address138 E Broad StCamilla, GA 31730-1809 · (229) 351-4125
Organization SubpartNo
Authorized OfficialKitty BeasleyGeneral Partner · (229) 328-7593
Enumeration DateMay 20, 2020
NPPES CertifiedMay 20, 2020
NPI 1760005144 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
138 E BROAD ST, Camilla, GA 31730

Other Identifiers 1

OtherXXXXxx

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 SINGLE SPECIALTY GROUP

Accepted 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 11D2188302

Camilla Medical Clinic · Camilla, GA
Active · expires Jul 14, 2028
CLIA Number11D2188302
Laboratory TypePhysician Office
Certificate Effective DateJuly 15, 2026
Certificate Expiration DateJuly 14, 2028
Laboratory DirectorKitty Beasley
Laboratory Phone(229) 351-4125
Laboratory LocationCamilla Medical Clinic138 East Broad Street, Camilla, GA 31730
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.

Nurse Practitioner (Family)
138 E BROAD ST
CAMILLA, GA 31730

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 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.

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.