JUBILEE FAMILY PRACTICE, LLC
NPI 1922860311
Nurse Practitioner - Family in Waycross, GA
About Jubilee Family Practice, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JUBILEE FAMILY PRACTICE, LLC (NPI 1922860311) is a healthcare organization registered as a family in Waycross, Georgia and active in the NPI registry since January 2024. The organization holds a CLIA Waiver certificate valid through March 14, 2028 and lists Katherine C Varnadore, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jubilee Family Practice, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Jubilee Family Practice, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 11D2300768
Jubilee Family Practice, LLC · Waycross, 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 Jubilee Family Practice, LLC's NPI number?
The NPI number for Jubilee Family Practice, LLC is 1922860311. It was assigned to this organization in the NPPES registry on January 30, 2024.
Where is Jubilee Family Practice, LLC located?
Jubilee Family Practice, LLC is located at 1415 Alice St, Waycross, GA 31501. The listed phone number is (912) 387-2186.
What is Jubilee Family Practice, LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jubilee Family Practice, LLC enrolled in Medicare?
Yes. Jubilee Family Practice, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jubilee Family Practice, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Jubilee Family Practice, LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Jubilee Family Practice, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D2300768) is associated with this NPI, valid through March 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Jubilee Family Practice, LLC was last updated on February 21, 2024. 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.
# Jubilee Family Practice, Llc · NPI 1922860311
Family organization in Waycross, Georgia. Organization record, active in the CMS NPPES registry since January 30, 2024.
## Identity
- **NPI:** 1922860311 (Entity type: Organization)
- **Enumerated:** January 30, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Katherine Varnadore, OWNER
## Practice location
- **Address:** 1415 ALICE ST, Waycross, GA 31501-4528
- **Phone:** (912) 387-2186 · **Fax:** (912) 387-4328
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 21, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1922860311) · Data from the CMS NPPES public registry.