HEART OF GEORGIA PRIMARY CARE, LLC
NPI 1780244301
Nurse Practitioner - Family in Eastman, GA

Active since June 17, 2019CLIA Certified · 2 labs
911 PLAZA AVE STE C, EASTMAN, GA 31023(478) 374-5774 Get Directions Write a Review

NPPES record last updated: February 23, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 23, 2022, Mar 24, 2021, Jun 17, 2019 (3 updates tracked since 2019).

About Heart Of Georgia Primary Care, Llc NPPES

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

HEART OF GEORGIA PRIMARY CARE, LLC (NPI 1780244301) is a healthcare organization registered as a family in Eastman, Georgia and active in the NPI registry since June 2019. The organization holds 2 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Amy H Cravey, Owner, as its authorized official.

NPPES Registry Identity

NPI1780244301
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameHEART OF GEORGIA PRIMARY CARE, LLC
Location Address911 PLAZA AVE STE CEastman, GA 31023-6786
Mailing Address911 Plaza Ave Ste CEastman, GA 31023-6786 · (478) 374-5774 · Fax (912) 374-9112
Organization SubpartNo
Authorized OfficialAmy H CraveyOwner · (478) 374-5774
Enumeration DateJune 17, 2019
Last NPPES UpdateFebruary 23, 20223 updates tracked since enumeration
NPPES CertifiedFebruary 23, 2022
NPI 1780244301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedFamily MedicineTaxonomy 207Q00000X
911 PLAZA AVE STE C, Eastman, GA 31023

Secondary Practice Locations 2

Location 1706 W Barnard StGlennville, GA 30427-3017 · Phone (912) 822-1941 · Fax (912) 822-1945
Location 2150 E Peacock St Ste ACochran, GA 31014-7847 · Phone (478) 271-3200 · Fax (478) 271-3205

Other Identifiers 2

Medicaid296546508FGA
OtherCS2005900319GA · Caresource Provider Number

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 2

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 11D2251022

Heart Of Georgia Primary Care LLC · Cochran, GA
Active · expires Jan 30, 2028
CLIA Number11D2251022
Laboratory TypePhysician Office
Certificate Effective DateJanuary 31, 2026
Certificate Expiration DateJanuary 30, 2028
Laboratory DirectorMichael Peacoch
Laboratory Phone(478) 271-3200
Laboratory LocationHeart Of Georgia Primary Care LLC150 E Peacock Street, Suite A, Cochran, GA 31014
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D0939131

Heart Of Georgia Primary Care, LLC · Eastman, GA
Active · expires Jan 20, 2028
CLIA Number11D0939131
Laboratory TypePhysician Office
Certificate Effective DateJanuary 21, 2026
Certificate Expiration DateJanuary 20, 2028
Laboratory DirectorMichael T. Peacock
Laboratory Phone(478) 374-5774
Laboratory LocationHeart Of Georgia Primary Care, LLC911 Plaza Ave Suite C, Eastman, GA 31023
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 3

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

Nurse Practitioner
911 PLAZA AVE STE C
EASTMAN, GA 31023
Nurse Practitioner (Family)
911 PLAZA AVE STE C
EASTMAN, GA 31023
Nurse Practitioner (Family)
911 PLAZA AVE STE C
EASTMAN, GA 31023

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 Heart Of Georgia Primary Care, LLC's NPI number?

The NPI number for Heart Of Georgia Primary Care, LLC is 1780244301. It was assigned to this organization in the NPPES registry on June 17, 2019.

Where is Heart Of Georgia Primary Care, LLC located?

Heart Of Georgia Primary Care, LLC is located at 911 Plaza Ave Ste C, Eastman, GA 31023. The listed phone number is (478) 374-5774.

What is Heart Of Georgia Primary Care, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Heart Of Georgia Primary Care, LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Heart Of Georgia Primary Care, LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Heart Of Georgia Primary Care, 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 Heart Of Georgia Primary Care, LLC was last updated on February 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.