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TATTNALL HOSPITAL COMPANY, LLC
NPI 1972762508
Clinic/Center - Rural Health in Glennville, GA

Active since June 09, 2008CLIA 11D1095526 · Waiver
1000B NORTH VETERANS BLVD, GLENNVILLE, GA 30427(912) 654-4599(912) 654-4648 Get Directions Write a Review

NPPES record last updated: January 14, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 14, 2026, Nov 20, 2025 (2 updates tracked since 2025).

About Tattnall Hospital Company, Llc NPPES

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

TATTNALL HOSPITAL COMPANY, LLC (NPI 1972762508), doing business as Optim Primary Care- Glennville, is a healthcare organization registered as a rural health in Glennville, Georgia and active in the NPI registry since June 2008. The organization holds a CLIA Waiver certificate valid through February 10, 2027 and lists David Alex Villa, Ceo, as its authorized official.

NPPES Registry Identity

NPI1972762508
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameTATTNALL HOSPITAL COMPANY, LLC
Location Address1000B NORTH VETERANS BLVDGlennville, GA 30427-8603
Mailing Address440 Mall Blvd Ste CSavannah, GA 31406-4868 · (912) 644-3340 · Fax (912) 644-5398
Phone(912) 654-4599
Fax(912) 654-4648
Organization SubpartNo
Authorized OfficialDavid Alex VillaCeo · (912) 629-7797
Enumeration DateJune 9, 2008
Last NPPES UpdateJanuary 14, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 14, 2026
✔ NPI 1972762508 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
1000B NORTH VETERANS BLVD, Glennville, GA 30427
Open in Google Maps ↗

Other Names 1

Doing Business AsOptim Primary Care- Glennville

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tattnall Hospital Company, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

49

Medicare enrollment records show 49 clinicians reassign Medicare billing to Tattnall Hospital Company, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 12

Orthopedic Surgery25
Nurse Practitioner11
Physical Medicine and Rehabilitation3
Family Practice2
Anesthesiology1
Diagnostic Radiology1
Hand Surgery1
Internal Medicine1
4 other specialties4

Nearest to this location (20)

See all 49
Jana Bunch, BSN, RN, MSN, FNP-BC
Nurse Practitioner
NPI 1598901696
1000 B. NORTH VETERANS BLVD
Glennville, GA 30427
(912) 654-4599
✔ PECOS✔ Accepts MedicareSame address
Joseph Hand, M.D.
Internal Medicine
NPI 1922057660
1002 N DOWNING MUSGROVE HWY
Glennville, GA 30427
(912) 654-4599
✔ PECOS✔ Accepts Medicare1.1 mi
Lisa Anderson, FNP-BC
Nurse Practitioner
NPI 1790145258
1000B NORTH VETERANS BOULEVARD
Glennville, GA 30427
(912) 654-4599
✔ PECOS✔ Accepts Medicare2.2 mi
Paul Ray, PT-ECS
Physical Therapist in Private Practice
NPI 1578500609
247 S MAIN ST
Reidsville, GA 30453
(912) 557-1000
✔ Accepts Medicare15 mi
Carol Alexander
Nurse Practitioner
NPI 1659922722
247 S MAIN ST
Reidsville, GA 30453
(912) 557-1000
✔ PECOS✔ Accepts Medicare15 mi
Sherry May, NP
Nurse Practitioner
NPI 1225273865
125 MEMORIAL DR
Reidsville, GA 30453
(912) 557-3434
✔ PECOS✔ Accepts Medicare15 mi
Cala Tanner
Nurse Practitioner
NPI 1114579331
125 MEMORIAL DR
Reidsville, GA 30453
(912) 644-5300
✔ PECOS✔ Accepts Medicare15 mi
Jay Cook, M.D.
Orthopedic Surgery
NPI 1790913622
110 PROFESSIONAL CT
Jesup, GA 31545
(912) 427-0800
✔ PECOS✔ Accepts Medicare22 mi
Joseph Hegarty, MD
Physical Medicine and Rehabilitation
NPI 1811942535
821 S MAIN ST STE C
Baxley, GA 31513
(912) 705-8040
✔ PECOS✔ Accepts Medicare26 mi
Jennifer Skinner
Nurse Practitioner
NPI 1144957671
821 S MAIN ST STE C
Baxley, GA 31513
(912) 644-5300
✔ PECOS✔ Accepts Medicare26 mi
John Robison, MD
Orthopedic Surgery
NPI 1477055606
3301 E 1ST ST STE A
Vidalia, GA 30474
(312) 537-4411
✔ PECOS✔ Accepts Medicare32 mi
Ronald Williams, MD
Otolaryngology
NPI 1184670036
1707 MEADOWS LN STE A
Vidalia, GA 30474
(912) 644-5300
✔ PECOS✔ Accepts Medicare33 mi
Joshua Wickstrom, MD
Family Practice
NPI 1275026908
380A CEDAR ST
Metter, GA 30439
(800) 827-6536
✔ PECOS✔ Accepts Medicare34 mi
William Tankersley, MD
Orthopedic Surgery
NPI 1700850948
16915 HIGHWAY 67 SOUTH SUITE A
Statesboro, GA 30458
(912) 681-2500
✔ PECOS✔ Accepts Medicare34 mi
Jessica Reyes, MD
Anesthesiology
NPI 1942707591
16915 HIGHWAY 67 STE A
Statesboro, GA 30458
(912) 644-5300
✔ PECOS✔ Accepts Medicare34 mi
Erica Mcdaniel, NP-C
Nurse Practitioner
NPI 1114430774
17007 HIGHWAY 67
Statesboro, GA 30458
(912) 681-2500
✔ PECOS✔ Accepts Medicare34 mi
Ruben Diaz, MD
Interventional Pain Management
NPI 1194751024
322 STEPHENSON AVE STE A
Savannah, GA 31405
(912) 721-2262
✔ PECOS✔ Accepts Medicare49 mi
Markus Niederwanger, MD
Physical Medicine and Rehabilitation
NPI 1508858887
322 STEPHENSON AVE STE A
Savannah, GA 31405
(912) 644-5300
✔ PECOS✔ Accepts Medicare49 mi
Gregory Kolovich, M.D.
Hand Surgery
NPI 1376849877
210 E DERENNE AVE
Savannah, GA 31405
(912) 644-5300
✔ PECOS✔ Accepts Medicare49 mi
Prakul Chandra, MD
Family Practice
NPI 1497911937
961 E WINTHROPE AVE
Millen, GA 30442
(478) 982-0120
✔ PECOS61 mi
See all 49 clinicians

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 11D1095526

Tattnal Hospital Company D/B/A Optim Primary Care-Glennville · Glennville, GA
Active · expires Feb 10, 2027
CLIA Number11D1095526
Laboratory TypeRural Health Clinic
Certificate Effective DateFebruary 11, 2025
Certificate Expiration DateFebruary 10, 2027
Laboratory DirectorJoshua Wickstrom
Laboratory Phone(912) 654-4599
Laboratory LocationTattnal Hospital Company D/B/A Optim Primary Care-Glennville1000 B N Veterans Blvd, Glennville, GA 30427
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Tattnall Hospital Company, LLC's NPI number?

The NPI number for Tattnall Hospital Company, LLC is 1972762508. It was assigned to this organization in the NPPES registry on June 9, 2008. The provider is doing business as Optim Primary Care- Glennville.

Where is Tattnall Hospital Company, LLC located?

Tattnall Hospital Company, LLC is located at 1000B North Veterans Blvd, Glennville, GA 30427. The listed phone number is (912) 654-4599.

What is Tattnall Hospital Company, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Is Tattnall Hospital Company, LLC enrolled in Medicare?

Yes. Tattnall Hospital Company, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tattnall Hospital Company, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 49 clinicians in 12 Medicare specialties reassign their Medicare billing to Tattnall Hospital Company, 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. The largest specialties are Orthopedic Surgery (25), Nurse Practitioner (11) and Physical Medicine and Rehabilitation (3). Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Tattnall Hospital Company, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D1095526) is associated with this NPI, valid through February 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Tattnall Hospital Company, 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 Tattnall Hospital Company, 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 Tattnall Hospital Company, LLC was last updated on January 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.