Justin Souter, NP
Individual provider Active NPI Family Nurse Practitioner · Colbert, GA
NPI 1205539293 · NPPES record last updated Oct 16, 2025
Key facts
- NPI
- 1205539293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN-NP306248 (GA)
- Practice address
- 11 Charlie Morris Rd
Colbert, GA 30628-2445 - Phone
- (706) 521-3113
- NPI assigned
- Mar 27, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Emory University School of Medicine, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Medlink Georgia Inc
Practice addresses (Care Compare)
247 Union Point St
Lexington, GA 30648-2303
Phone (706) 743-8171
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230731000551 | GA | Practitioner - Nurse Practitioner | 2961863584 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN-NP306248 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medlink Georgia Inc | Current |
Accepting new patients | |
| Medlink Georgia, Inc | Current |
Accepting new patients | |
| Medlink Georgia Inc | Past | Accepting new patients |
Locations
11 Charlie Morris Rd
Bldg 2
Colbert, GA 30628
Phone (706) 738-3234
11 Charlie Morris Rd
Colbert, GA 30628
Phone (706) 738-3234
980 Lawrenceville Hwy
Lawrenceville, GA 30046
Phone (770) 676-6500
247 Union Point St
Lexington, GA 30648
Phone (706) 743-8171
133 W Athens St
Winder, GA 30680
Phone (770) 867-6633
Interoperability endpoints
- justin.souter.1@9864.direct.athenahealth.com
- justin.souter@mgi.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN-NP306248 | GA | Yes |
Addresses
Primary practice location
11 Charlie Morris Rd
Colbert, GA 30628-2445
Mailing address
11 Charlie Morris Rd
Colbert, GA 30628-2445
Other providers in Colbert, GA
- Reno James Roberts
- Michael Brian Rountree
- Sarah Sammons
- Lonnie K Sipsy
- Savannah Leigh Smith
- Southern Medical Transport
- Jonathan Spaulding
- Linda Tejada Mahomar
- The Hampton House Facility, LLC
- Akilah S Tomingas
All providers in Colbert, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2025. 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.
- Order and Referring (CMS).
- 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.