NPIMap

Organization Active NPI

Southeast Georgia Health Services, L.L.C.

Doing business as Memorial Satilla Health

  • Psychiatric Hospital Unit
  • Waycross, GA
National Provider Identifier
1093248486
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
SOUTHEAST GEORGIA HEALTH SERVICES, L.L.C.
Doing business as
Memorial Satilla Health
Practice address
1900 Tebeau St
Waycross, GA 31501-6357
Phone
(912) 283-3030
Fax
(912) 287-2505
NPI assigned
Apr 4, 2017
Last updated
Sep 24, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHEAST GEORGIA HEALTH SERVICES, L.L.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Authorized official

Name
Tim Lynch
Title
Interim Cfo
Phone
(912) 287-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

1900 Tebeau St
Waycross, GA 31501-6357

Mailing address

1900 Tebeau St
Waycross, GA 31501-6357
Phone (912) 283-3030

Other names 1

  • Memorial Satilla Health Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170713002941 GA Part A Provider - Hospital 8123395928 Practice locations: Waycross, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093248486. Details of each certification follow.

Hospital certification: CCN 11S003

Legal name
SOUTHEAST GEORGIA HEALTH SERVICES, LLC
Doing business as
MEMORIAL SATILLA HEALTH
Organization structure
LLC
Incorporated
Oct 18, 2016 in DE
Enrollment address
2500 Satilla Pkwy
Waycross, GA 31503-8852
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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).

National Provider Directory

National Provider Directory
Tax ID family
Southeast Georgia Health Services LLC6 organizations share this tax ID, including this one
Part of
Southeast Georgia Health Services LLC

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
HCA Inc Organization, Nashville, TN Corporation, For-profit, Chain home office 5% Or Greater Indirect Ownership Interest Oct 18, 2016 100%
Eric D Smith Individual Contracted Managing EmployeeVice President of Reimbursement Mar 1, 2021
Other Mar 1, 2021
HCA Healthcare Inc Organization, Nashville, TN Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Oct 18, 2016 100%
David Alan Wylie Individual Corporate OfficerCfo Dec 31, 2025
W-2 Managing EmployeeCfo Dec 31, 2025
Hercules Holding II Organization, Nashville, TN Holding company 5% Or Greater Indirect Ownership Interest Oct 18, 2016 23%
Healthtrust Inc - the Hospital Company Organization, Nashville, TN Corporation, For-profit 5% Or Greater Indirect Ownership Interest Oct 18, 2016 100%
Frisco Holding II Organization, Nashville, TN Corporation, Investment firm, For-profit 5% Or Greater Indirect Ownership Interest Oct 18, 2016 12.19%
Hti Hospital Holdings Inc Organization, Nashville, TN Corporation, Holding company, For-profit 5% Or Greater Direct Ownership Interest Oct 18, 2016 100%
Damon Luke Barrett Individual Corporate OfficerCeo Sep 2, 2025
W-2 Managing EmployeeCeo Sep 2, 2025

Facilities with the same owner 191

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

View all 191

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758672000000",
    "number": "1093248486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 TEBEAU ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016357",
            "telephone_number": "912-283-3030",
            "fax_number": "912-287-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 TEBEAU ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016357",
            "telephone_number": "912-283-3030",
            "fax_number": "912-287-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST GEORGIA HEALTH SERVICES, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEAST GEORGIA HEALTH SERVICES, L.L.C.",
        "enumeration_date": "2017-04-04",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "INTERIM CFO",
        "authorized_official_telephone_number": "912-287-2500"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Memorial Satilla Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.