NPIMap

Organization Active NPI

Screven County Hospital LLC

Doing business as Optim Primary Care Millen

  • Rural Health Clinic/Center
  • Millen, GA
National Provider Identifier
1033428214
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SCREVEN COUNTY HOSPITAL LLC
Doing business as
Optim Primary Care Millen
Practice address
961 E Winthrope Ave
Millen, GA 30442-1839
Phone
(478) 982-9081
Fax
(478) 982-8843
NPI assigned
Oct 5, 2010
Last updated
Nov 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Authorized official

Name
David Alex Villa
Title
Ceo
Phone
(505) 695-9410

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X GA Primary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

961 E Winthrope Ave
Millen, GA 30442-1839

Mailing address

460 Mall Blvd Ste B
Savannah, GA 31406-4891
Phone (912) 644-1626

Other names 1

  • Optim Primary Care Millen Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20110126000836 GA Part B Supplier - Clinic/Group Practice 0143419820 Receives reassigned benefits from 5 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Millen, GA
O20110321000565 GA Part B Supplier - Clinic/Group Practice 5496944712 Receives reassigned benefits from 4 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Millen, GA; Sylvania, GA
O20171013000961 GA Part A Provider - Rural Health Clinic 5496944712 Practice locations: Millen, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033428214. Details of each certification follow.

Rural health clinic certification: CCN 118513

Legal name
SCREVEN COUNTY HOSPITAL LLC
Doing business as
OPTIM PRIMARY CARE - MILLEN
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 30, 2006
Last certification
Jan 29, 2026
Ownership / control type
1B
Most recent change of ownership
Jun 16, 2017 (2 total)
Organization structure
LLCProprietary
Incorporated
Jun 28, 2010 in GA
Enrollment address
961 E Winthrope Ave
Millen, GA 30442-1839
Related CCNs
111312

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 12

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

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
11D2045335Screven County Hospital, LLC961 East Winthrope Avenue, Millen, GA 30442Certificate of waiverAug 9, 2026

National Provider Directory

National Provider Directory

Locations

961 E Winthrope Ave
Ste B
Millen, GA 30442

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
SP Holdco I Inc Organization, Brentwood, TN Corporation, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2017 100%
National Surgical Hospitals, LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest May 31, 2015 100%
Jennifer B Baldock Individual Corporate OfficerOfficer and Authorized Official Sep 1, 2017
Bcpe Seminole Holdings, LP Organization, Boston, MA 5% Or Greater Indirect Ownership Interest Sep 1, 2017
Community Hospital Management Company LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Direct Ownership Interest Jul 1, 2010 100%
Surgery Partners Inc Organization, Brentwood, TN Corporation, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2017 100%
Community Hospital Holding Company, LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2010 100%
Surgery Center Holdings Inc Organization, Brentwood, TN Corporation, For-profit, Chain home office 5% Or Greater Indirect Ownership Interest Sep 1, 2017
David Alex Villa Individual Corporate OfficerCeo Oct 1, 2024
W-2 Managing EmployeeCeo Oct 1, 2024
Bradley R Owens Individual OtherNational Group President and Chain Dec 2, 2019
NSH Georgia Inc Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest May 31, 2015 100%
Surgery Center Holdings LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2017 100%

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Optim Primary Care- SlyvaniaSylvania, GA, CCN 118550 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 7, 2011
Sep 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 23

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • Screven County Family Health Center, LLC

    dba Optim Primary Care - Sylvania

    • Rural Health Clinic/Center
    • Sylvania, GA
    • NPI 1841432044

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Screven County Hospital LLC

    dba Optim Medical Center - Screven

    • Medicare Defined Swing Bed Hospital Unit
    • Sylvania, GA
    • NPI 1083915524

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, Community Hospital Management Company LLC, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery P

    CMS ownership
  • Screven County Hospital, LLC

    dba Optim Medical Center - Screven

    • Critical Access Hospital
    • Sylvania, GA
    • NPI 1225339898

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, Community Hospital Management Company LLC, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery P

    CMS ownership
  • Tattnall Hospital Company LLC

    dba Optim Medical Center - Tattnall

    • Medicare Defined Swing Bed Hospital Unit
    • Reidsville, GA
    • NPI 1740440932

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Tattnall Hospital Company, LLC

    dba Optim Primary Care Metter

    • Rural Health Clinic/Center
    • Metter, GA
    • NPI 1285132415

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Tattnall Hospital Company, LLC

    dba Optim Primary Care-Reidsville

    • Rural Health Clinic/Center
    • Reidsville, GA
    • NPI 1285893818

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Tattnall Hospital Company, LLC

    dba Optim Medical Center - Tattnall

    • Critical Access Hospital
    • Reidsville, GA
    • NPI 1790942381

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Tattnall Hospital Company, LLC

    dba Optim Primary Care- Glennville

    • Rural Health Clinic/Center
    • Glennville, GA
    • NPI 1972762508

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Animas Surgical Hospital, LLC

    dba Animas Surgical Hospital

    • General Acute Care Hospital
    • Durango, CO
    • NPI 1508842964

    Bcpe Seminole Holdings, LP, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Arizona Spine and Joint Hospital LLC
    • General Acute Care Hospital
    • Mesa, AZ
    • NPI 1396745832

    Bcpe Seminole Holdings, LP, National Surgical Hospitals, LLC, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Brazos Valley Physicians Organization,Mso-LLC

    dba The Physicians Pain and Spine Centre

    • General Acute Care Hospital
    • Bryan, TX
    • NPI 1801817135

    National Surgical Hospitals, LLC, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • CMSC, LLC

    dba Great Falls Clinic Hospital

    • General Acute Care Hospital
    • Great Falls, MT
    • NPI 1639109978

    Bcpe Seminole Holdings, LP, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
View all 23

Change-of-ownership history 2

DateEventCounterparty
Jun 16, 2017 Change of OwnershipThis provider was the buyer Optim Primary Care-MillenCCN 118513, GA, NPI 1033428214
Jun 16, 2017 Change of OwnershipThis provider was the seller Optim Primary Care - MillenCCN 118513, GA, NPI 1033428214

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1033428214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 MALL BLVD STE B",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064891",
            "telephone_number": "912-644-1626",
            "fax_number": "912-644-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 E WINTHROPE AVE",
            "city": "MILLEN",
            "state": "GA",
            "postal_code": "304421839",
            "telephone_number": "478-982-9081",
            "fax_number": "478-982-8843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCREVEN COUNTY HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "VILLA",
        "authorized_official_first_name": "DAVID ALEX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-695-9410"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optim Primary Care Millen",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Optim Primary Care Millen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Millen, GA

Sources for this page

Verify at the official NPI Registry.