WILDWOOD MEDICAL CLINIC
NPI 1902957541
General Acute Care Hospital in Wildwood, GA
About Wildwood Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WILDWOOD MEDICAL CLINIC (NPI 1902957541) is a healthcare organization registered as a general acute care hospital in Wildwood, Georgia and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through December 8, 2027 and lists Vaughan Harvey Sparrow, Hospital Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 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)
Wildwood Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Wildwood Medical Clinic, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
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 11D0021709
Wildwood Medical Clinic Laboratory · Wildwood, 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 Wildwood Sanitarium Incorporated's NPI number?
The NPI number for Wildwood Sanitarium Incorporated is 1902957541. It was assigned to this organization in the NPPES registry on January 12, 2007. The provider is doing business as Wildwood Medical Clinic.
Where is Wildwood Sanitarium Incorporated located?
Wildwood Sanitarium Incorporated is located at 435 Lifestyle Lane, Wildwood, GA 30757. The listed phone number is (706) 820-1493.
What is Wildwood Sanitarium Incorporated's specialty?
The primary specialty registered for this NPI is General Acute Care Hospital with taxonomy code 282N00000X.
Is Wildwood Sanitarium Incorporated enrolled in Medicare?
Yes. Wildwood Sanitarium Incorporated is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Wildwood Sanitarium Incorporated?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Wildwood Sanitarium Incorporated, in Internal Medicine 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, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Wildwood Sanitarium Incorporated hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D0021709) is associated with this NPI, valid through December 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Wildwood Sanitarium Incorporated accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Wildwood Sanitarium Incorporated 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 Wildwood Sanitarium Incorporated was last updated on August 12, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Wildwood Medical Clinic · NPI 1902957541
General Acute Care Hospital organization in Wildwood, Georgia. Organization record, active in the CMS NPPES registry since January 12, 2007.
## Identity
- **NPI:** 1902957541 (Entity type: Organization)
- **Enumerated:** January 12, 2007
- **Primary specialty:** General Acute Care Hospital · taxonomy 282N00000X
- **Legal business name:** Wildwood Sanitarium Incorporated
- **Organization subpart:** No
- **Authorized official:** Vaughan Sparrow, HOSPITAL ADMINISTRATOR
## Practice location
- **Address:** 435 LIFESTYLE LANE, Wildwood, GA 30757-0129
- **Phone:** (706) 820-1493
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (2), Nurse Practitioner (2); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 12, 2010
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1902957541) · Data from the CMS NPPES public registry.