George William Durrell IV, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

12628 Issued in GA

Practice address

1497 Fair Rd Ste 200
Statesboro, GA 30458-0824

Phone

(912) 871-7100

Fax

(912) 871-7110

NPI assigned

Aug 22, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Georgia Hma Physician Management LLCGroup PAC ID 7214068592, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: george.durrell.1@8824.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• East Georgia Hma Physician Management, LLC

  • Internal Medicine Physician
  • Statesboro, GA
  • NPI 1487983151
  Medicare reassignment Care Compare group
• Montgomery Emergency Group, LLC

  • Emergency Medicine Physician
  • Vidalia, GA
  • NPI 1861773764

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  Care Compare affiliation

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1053144238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "912-871-7100",
            "fax_number": "912-871-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 FAIR RD STE 200",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580824",
            "telephone_number": "912-871-7100",
            "fax_number": "912-871-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURRELL",
        "first_name": "GEORGE",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-22",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12628",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "12628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "george.durrell.1@8824.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1497 Fair Rd Ste 200",
            "city": "Statesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304580824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kyla Ann Duncan, PA-C
• Roderick Rashond Dunham, DMD
• Martiya Lachar Dunn
• Durden & Riggs Pharmacy
• Kim G Durfee, LPC
• Elizabeth Durst
• Michael D Dykes, MD
• Deborah Susan Dzurinko, MPT
• E Plus Statesboro Cancer Care, LLC
• Eagle Eye Care

• Surgical Physician Assistant in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.