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MALOZERA PRIMARY CARE, LLC
NPI 1912544784
Family Medicine in Unadilla, GA

Active since November 29, 2019CLIA 11D2285307 · Waiver
2809 PINE ST, UNADILLA, GA 31091(478) 355-3000(478) 355-3001 Get Directions Write a Review

NPPES record last updated: November 18, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 18, 2023, Aug 14, 2020, Nov 29, 2019 (3 updates tracked since 2019).

About Malozera Primary Care, Llc NPPES

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

MALOZERA PRIMARY CARE, LLC (NPI 1912544784) is a healthcare organization registered as a family medicine in Unadilla, Georgia and active in the NPI registry since November 2019. The organization holds a CLIA Waiver certificate valid through July 10, 2027, maintains 2 additional practice locations, and lists Alexander C Ibezi-enendu, Owner, as its authorized official.

NPPES Registry Identity

NPI1912544784
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMALOZERA PRIMARY CARE, LLC
Location Address2809 PINE STUnadilla, GA 31091-7701
Mailing AddressP O Box 8203Warner Robins, GA 31095-8203 · (478) 783-3610 · Fax (478) 783-3611
Phone(478) 355-3000
Fax(478) 355-3001
Organization SubpartNo
Authorized OfficialAlexander C Ibezi-enenduOwner · (404) 702-9466
Enumeration DateNovember 29, 2019
Last NPPES UpdateNovember 18, 20233 updates tracked since enumeration
NPPES CertifiedNovember 18, 2023
✔ NPI 1912544784 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.
2809 PINE ST, Unadilla, GA 31091
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1604 Bluebird BlvdFort Valley, GA 31030-5081 · Phone (478) 352-2031 · Fax (478) 825-2041
Location 2292 Industrial Blvd Ste 300Hawkinsville, GA 31036-8034 · Phone (478) 783-3610 · Fax (478) 783-3611

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

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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 11D2285307

Malozera Primary Care,llc · Unadilla, GA
Active · expires Jul 10, 2027
CLIA Number11D2285307
Laboratory TypePhysician Office
Certificate Effective DateJuly 11, 2025
Certificate Expiration DateJuly 10, 2027
Laboratory DirectorAlexander C. Ibezi-Enendu
Laboratory Phone(478) 783-3610
Laboratory LocationMalozera Primary Care,llc2809 Pine Street, Unadilla, GA 31091
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.

KIMBERLY CRUMP JOHNSON NP-C
Nurse Practitioner
2809 PINE ST
UNADILLA, GA 31091
Dooly County (478) 627-3213
ALEXANDER CHUKWUMA IBEZI-ENENDU D.O.
Family Medicine
2809 PINE ST
UNADILLA, GA 31091
Dooly County (478) 355-3000
MS. BIANCA LESTER MCBURSE FNP-BC
Nurse Practitioner (Family)
2809 PINE ST
UNADILLA, GA 31091
Dooly County (478) 355-3000

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 Malozera Primary Care, LLC's NPI number?

The NPI number for Malozera Primary Care, LLC is 1912544784. It was assigned to this organization in the NPPES registry on November 29, 2019.

Where is Malozera Primary Care, LLC located?

Malozera Primary Care, LLC is located at 2809 Pine St, Unadilla, GA 31091. The listed phone number is (478) 355-3000.

What is Malozera Primary Care, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Malozera Primary Care, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2285307) is associated with this NPI, valid through July 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Malozera 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 Malozera 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 Malozera Primary Care, LLC was last updated on November 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.