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COFFEE REGIONAL MEDICAL CENTER
NPI 1992999205
Clinic/Center in Douglas, GA

Active since August 29, 2007
1101 OCILLA RD, DOUGLAS, GA 31533(912) 384-1900(912) 389-2105 Get Directions Write a Review

NPPES record last updated: August 29, 2007. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Coffee Regional Medical Center NPPES

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

COFFEE REGIONAL MEDICAL CENTER (NPI 1992999205) is a healthcare organization registered as a clinic/center in Douglas, Georgia and active in the NPI registry since August 2007. The organization lists Elaine F Lord, Medical Staff Assistant, as its authorized official.

NPPES Registry Identity

NPI1992999205
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameCOFFEE REGIONAL MEDICAL CENTER
Location Address1101 OCILLA RDDouglas, GA 31533-2207
Mailing Address1101 Ocilla RdDouglas, GA 31533-2207 · (912) 384-1900 · Fax (912) 389-2105
Phone(912) 384-1900
Fax(912) 389-2105
Organization SubpartNo
Authorized OfficialElaine F LordMedical Staff Assistant · (912) 383-5623
Enumeration DateAugust 29, 2007
✔ NPI 1992999205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in GA · 03941
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
1101 OCILLA RD, Douglas, GA 31533
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Coffee Regional Medical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateGeorgiaEnrollment IDO20040402000287Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

72

Medicare enrollment records show 72 clinicians reassign Medicare billing to Coffee Regional Medical Center, which bills Medicare for the services they deliver. Of these, 25 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 14

Certified Registered Nurse Anesthetist (CRNA)19
Critical Care (Intensivists)13
Cardiovascular Disease (Cardiology)9
Internal Medicine7
Nurse Practitioner6
Anesthesiology5
Emergency Medicine3
Family Practice2
6 other specialties8

Nearest to this location (20)

See all 72
Sarah Briceno
Certified Registered Nurse Anesthetist (CRNA)
NPI 1154036341
1101 OCILLA RD
Douglas, GA 31533
(912) 384-1900
✔ Accepts Medicare0.1 mi
Patricia Collins-Young, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1619933975
1101 OCILLA RD
Douglas, GA 31533
(800) 232-5703
✔ Accepts Medicare0.1 mi
Thomas Henris, MD
Anesthesiology
NPI 1740245687
1101 OCILLA RD
Douglas, GA 31533
(800) 232-5703
✔ PECOS✔ Accepts Medicare0.1 mi
Dianna Chaney, NP-C
Nurse Practitioner
NPI 1881078087
1101 OCILLA RD
Douglas, GA 31533
(912) 384-1900
✔ PECOS✔ Accepts Medicare0.1 mi
Charles Cowart, MD
Internal Medicine
NPI 1871694448
1101 OCILLA RD
Douglas, GA 31533
(912) 384-1900
✔ PECOS✔ Accepts Medicare0.1 mi
Shirley Harrell, NP
Nurse Practitioner
NPI 1629041355
1101 OCILLA RD
Douglas, GA 31533
(912) 384-1900
✔ PECOS0.1 mi
Stuart Osteen, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1417905357
1101 OCILLA RD
Douglas, GA 31533
(800) 232-5703
✔ Accepts Medicare0.1 mi
Laura Steverson, NP-C
Nurse Practitioner
NPI 1871010264
1101 OCILLA RD
Douglas, GA 31533
(912) 384-1900
✔ PECOS0.1 mi
Jeffery Winge, M.D.
Emergency Medicine
NPI 1770516361
205 SHIRLEY AVE
Douglas, GA 31533
(912) 383-6966
✔ PECOS✔ Accepts Medicare0.2 mi
Manish Bansal, MD
Cardiovascular Disease (Cardiology)
NPI 1811903222
1305 OCILLA RD
Douglas, GA 31533
(912) 384-0600
✔ PECOS✔ Accepts Medicare0.2 mi
Willie Bell, MD
Cardiovascular Disease (Cardiology)
NPI 1205834181
1305 OCILLA RD
Douglas, GA 31533
(912) 384-0600
✔ PECOS✔ Accepts Medicare0.2 mi
Glenn Evans, MD
Cardiovascular Disease (Cardiology)
NPI 1285623744
1305 OCILLA RD
Douglas, GA 31533
(912) 384-0600
✔ PECOS✔ Accepts Medicare0.2 mi
Joel Ferree, MD
Cardiovascular Disease (Cardiology)
NPI 1245238211
1305 OCILLA RD
Douglas, GA 31533
(912) 384-0600
✔ PECOS✔ Accepts Medicare0.2 mi
James Sinclair, M.D.
Internal Medicine
NPI 1437142320
306 WESTSIDE DR
Douglas, GA 31533
(912) 389-8610
✔ PECOS✔ Accepts Medicare0.2 mi
John Arnett, M.D.
Internal Medicine
NPI 1225021678
200 DOCTORS DR SUITE 106
Douglas, GA 31533
(912) 384-3338
✔ PECOS✔ Accepts Medicare0.2 mi
Mark Brulte, MD
Internal Medicine
NPI 1205931672
200 DOCTORS DR SUITE 106
Douglas, GA 31533
(912) 384-3338
✔ PECOS✔ Accepts Medicare0.2 mi
Justin Harrell, M.D.
Family Practice
NPI 1285756163
200 DOCTORS DRIVE SUITE 106
Douglas, GA 31533
(912) 384-3338
✔ PECOS✔ Accepts Medicare0.2 mi
Hemachandran Nair, M.D.
Cardiovascular Disease (Cardiology)
NPI 1750374294
200 DOCTORS DR SUITE 106
Douglas, GA 31533
(912) 384-3338
✔ PECOS✔ Accepts Medicare0.2 mi
Charles Bagwell, MD
General Surgery
NPI 1366417479
100 DOCTORS DR STE C
Douglas, GA 31533
(912) 384-5832
✔ PECOS✔ Accepts Medicare0.2 mi
Maria Gomez, RN, MSN, APRN, FNP-C
Nurse Practitioner
NPI 1144849290
1111 BAKER HWY W
Douglas, GA 31533
(912) 389-4453
✔ PECOS0.6 mi
See all 72 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Coffee Regional Medical Center's NPI number?

The NPI number for Coffee Regional Medical Center is 1992999205. It was assigned to this organization in the NPPES registry on August 29, 2007.

Where is Coffee Regional Medical Center located?

Coffee Regional Medical Center is located at 1101 Ocilla Rd, Douglas, GA 31533. The listed phone number is (912) 384-1900.

What is Coffee Regional Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Coffee Regional Medical Center enrolled in Medicare?

Yes. Coffee Regional Medical Center is registered in the Medicare PECOS enrollment system.

When is Coffee Regional Medical Center's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Coffee Regional Medical Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 72 clinicians in 14 Medicare specialties reassign their Medicare billing to Coffee Regional Medical Center. 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 Certified Registered Nurse Anesthetist (CRNA) (19), Critical Care (Intensivists) (13) and Cardiovascular Disease (Cardiology) (9). Of these, 25 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Coffee Regional Medical Center was last updated on August 29, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.