Individual provider Active NPI

Cynthia Blair Chambless, MD

  • Family Medicine Physician
  • Macon, GA
National Provider Identifier
1063577500
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
030975 Issued in GA
Practice address
197 Bass Rd
Macon, GA 31210-2060
Phone
(478) 477-0966
Fax
(478) 254-3146
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 030975 GA Primary

Addresses

Primary practice location

197 Bass Rd
Macon, GA 31210-2060

Mailing address

197 Bass Rd
Macon, GA 31210-2060
Phone (478) 477-0966

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040517001540 GA Practitioner - Family Practice 3779573027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mercer University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern Primary Care, LLCGroup PAC ID 3173897196, 5 clinicians

Practice addresses (Care Compare)

197 Bass Rd
Macon, GA 31210-2060
Phone (478) 477-0966

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Primary Care, LLC CurrentSince Mar 1, 2024 Accepting new patients

Locations

6501 Peake Rd
Ste 400
Macon, GA 31210
Phone (478) 477-0966

6501 Peake Rd
Ste 200
Macon, GA 31210
Phone (470) 475-1413

197 Bass Rd
Macon, GA 31210
Phone (478) 365-2164

Interoperability endpoints

  • Direct secure messaging: cynthia.chambless@spcamga.eclinicaldirectplus.com

Organizations & group practices 1

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

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1063577500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 BASS RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102060",
            "telephone_number": "478-477-0966",
            "fax_number": "478-254-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 BASS RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102060",
            "telephone_number": "478-477-0966",
            "fax_number": "478-254-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBLESS",
        "first_name": "CYNTHIA",
        "middle_name": "BLAIR",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "030975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.