Rural Urgent Care LLC
Organization Active NPI Urgent Care Clinic/Center · Hazlehurst, GA
NPI 1093384497 · NPPES record last updated Mar 20, 2026
Key facts
- NPI
- 1093384497
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- RURAL URGENT CARE LLC
- Practice address
- 162 East Jarman St.
Hazlehurst, GA 31539 - Phone
- (912) 209-0239
- Fax
- (912) 209-5092
- NPI assigned
- Jun 21, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- RURAL URGENT CARE LLC
Authorized official
- Name
- Krista Rock
- Title
- VP
- Phone
- (205) 545-5090
Owned or controlled facilities with NPI records 4
Other NPIs with the same Medicare PAC ID 20
Practitioners 171
-
Porsche Adams, FNP
-
Ashley Arnwine, FNP-C
-
Natalia Berman, NP
-
Ashlie Jordyn Burrow, FNP-C
-
Jorge L Coyago, FNP
-
Betsy Diaz, FNP-C
-
Elizabeth Sha Duque, APRN
-
Katherine Love Edelen, PA-C
-
January Michelle Floyd, FNP-C
-
Olivia Hamman, PA
-
Rilla Margaret Highsmith, FNP-C
-
Anna Horne, PA
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2227480 | Rural Urgent Care | Certificate of waiver | Jun 13, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Mainstreet Family Care - Forest City |
Rural health clinic | Operational/Managerial Control (100%) | Apr 15, 2021 |
| Mainstreet Family Care - Oxford |
Rural health clinic | Operational/Managerial Control (100%) | Apr 15, 2021 |
| Mainstreet Family Care - Liberty |
Rural health clinic | Operational/Managerial Control (100%) | Apr 15, 2021 |
| Mainstreet Family Care - Tarboro |
Rural health clinic | Operational/Managerial Control (100%) | Apr 15, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210930002230 | GA | DME Supplier - Physician - Family Practice | 8820305600 | Practice locations: Hazlehurst, GA |
National Provider Directory
- Part of
- Rural Urgent Care LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
162 East Jarman St.
Hazlehurst, GA 31539
Mailing address
1500 1St Ave N Unit 3
Birmingham, AL 35203-1866
Phone (205) 545-5085
Other names
- MainStreet Family Care
Other providers in Hazlehurst, GA
- Giselle Reddy
- Melissa Suzanne Register
- Gina Williams Roberts
- John J Rogers
- Jerri-Ann Rowell
- Scott J Waguespack MD/Family Healthcare
- Sara Ellen Sears
- David L Shumans
- Sidney P Johnson, M.D. P.C
- Southeast Georgia Homehealth Care Inc.
All providers in Hazlehurst, GA · Urgent Care Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.