NPIMap

Organization Active NPI

St. Mary'S Medical Group, Inc.

  • Rheumatology Physician
  • Watkinsville, GA
National Provider Identifier
1003264524
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
ST. MARY'S MEDICAL GROUP, INC.
Practice address
1181 Langford Dr BLDG 200-103
Watkinsville, GA 30677-7304
Phone
(706) 769-9931
Fax
(706) 310-0499
NPI assigned
May 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brittainy Horne
Title
President
Phone
(706) 389-3940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X Primary

Addresses

Primary practice location

1181 Langford Dr BLDG 200-103
Watkinsville, GA 30677-7304

Mailing address

PO Box 48089
Athens, GA 30604-8089
Phone (706) 389-3740

Other names 1

  • Rheumatology Center of Athens Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080616000388 GA Part B Supplier - Clinic/Group Practice 7113098393 Receives reassigned benefits from 126 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Athens, GA; Bogart, GA; Greensboro, GA; Lavonia, GA; Monroe, GA; Watkinsville, GA

Other NPIs on the same Medicare enrollment 28

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 28

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2291319Rheumatology Center of Athens1181 Langford Dr BLDG 200 Suite 103, Watkinsville, GA 30677Certificate of waiverOct 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
St Mary'S Medical Group Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

2421 Malcom Bridge Rd
Ste 420
Bogart, GA 30622
Phone (706) 208-8038

1622 Mars Hill Rd
Watkinsville, GA 30677
Phone (678) 863-5225

1181 Langford Dr
Bldg 200-103
Watkinsville, GA 30677
Phone (706) 769-9931

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1003264524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48089",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306048089",
            "telephone_number": "706-389-3740",
            "fax_number": "706-389-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 LANGFORD DR BLDG 200-103",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777304",
            "telephone_number": "706-769-9931",
            "fax_number": "706-310-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-25",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "HORNE",
        "authorized_official_first_name": "BRITTAINY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-389-3940"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rheumatology Center of Athens",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Rheumatology Center of Athens",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Watkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.